1. Getting Your Change Project Started with the Quick Start Road Map
Reduce Waiting & No-Shows  Increase Admissions & Continuation

2. “I always wanted to be somebody. I should have been more specific. ”
“I always wanted to be somebody. I should have been more specific.” Lily Tomlin

3. Specifying the Aim What is the problem we want to address?
Does solving this problem make a difference to consumers, the organization, the CEO?
State the problem concisely in one to two sentences.

4. Specifying the Measure
How will we know if we have made an improvement?
Is the measure clear and easy to use?
Can the change team collect data by hand and see results weekly?

5. Who will lead the project?
Enthusiastic
Well respected by peers
Able to facilitate
Open to change
Can move the team forward
Has time to devote to the project

6. How will Exec Sponsor Introduce the Project?
Why is it important?
Why is this team charged with working on it?
What are expectations for team in terms of responsibility and accountability?
How will outcomes be used?

7. Develop List of Possible Causes of Problem
Restate problem from multiple viewpoints
Example: Many people in our area are unaware of services we offer to families of consumers
Pregnant women don’t know we offer child care
Physicians don’t know we offer parenting classes
Hispanic community doesn’t know we offer classes in Spanish

8. Challenge Assumptions
Clear deck of old ideas
Consider everything you “know” to be true about a service or process you currently do
Examine each assumption in turn (no matter how logical) and ask yourself – “What if it’s not necessarily the case?”
Oakland A’s (earned run avg vs. on base avg)
Boston Standup Stapler
KB Homes (people want basements)

9. Utilizing Nominal Group for Brainstorming Ideas
State the topic for brainstorming in one or two sentences
Spend 5 min. silently generating ideas
Each person in group takes a turn listing one of his/her ideas
List each idea on a flip chart
Continue around the group in turn until no one has any ideas to add

10. Clean up and Grouping Check the list Eliminate duplicates
Put similar ideas together

11. Discussion Yes/And – any ways to creatively combine ideas?
Which ideas are the simplest?
Which ideas do you believe will bring you an early win?
Which ideas are most likely to give you the biggest gains?
Any ideas that seem particularly long or difficult to implement?

12. Voting
Each group member gets 5 votes to distribute among the ideas. These votes can be spread among one to five ideas.
Let each member place 5 checks on flip chart next to their favorite ideas.
Count votes then discuss the top choices and vote for top pick

13. NIATx Members’ Promising Practices
Increasing Access and Retention

14. Strategies for Reducing Waiting Time
Answer phone live.
Reduce intake and assessment paperwork.
Offer assessments every day and in the evenings.
Use open schedules, i.e. any time a counselor is available; cross-train staff
Double book assessments.
Allow walk-in appointments.

15. Strategies for Reducing No-shows
Get the consumer to the first appointment quickly.
Address barriers to attending appointment.
Explain what to expect at appointment.
Model communication with the consumer using Motivational Interviewing/Enhancement Techniques.
Make reminder calls.

16. Strategies for Increasing Continuation
Scheduling:
Connect consumer to counselor and support staff within 24 hours of admission
Provide reminders for appointments treatment;
adjust staff schedules if needed.
Provide welcome orientation and establish clear two-way expectations; assign a peer buddy.
Identify consumers at risk of leaving and barriers to continuing in treatment on an ongoing basis.

17. Strategies for Increasing Continuation
Maintain counselor resiliency with staff collaboration and personal care/development.
Tailor treatment to consumer’s individual circumstances and needs.
Along with a variety of educational and treatment activities, have FUN.
Offer positive reinforcements for continuing in treatment.

18. Strategies for Enhancing Capacity
Build capacity: Develop/expand new or existing programs.
Reshape capacity: Reduce admission steps and/or reduce paperwork

19. Remember to:
Keep a parking lot list of your change cycle ideas and any other creative thoughts – revisit regularly
Include all voices to gain maximum brain power and diversity of ideas (e.g. nominal group)
Keep it simple and have fun!

20. What’s Next? Phone Conferences with Exec Sponsors
Phone Conferences with Change Teams
Another Face to Face meeting?