1. Overview Spectrum Health Systems Increase Census Project Milford, Framingham and Southbridge Outpatient Kristin Nolan, MA, Director of Outpatient Services Karen Hewitt, BS, Program Director Mark Orris, Program Director

2. AIM (Plan) Identified need to increase client census in the smaller outpatient opiate treatment programs. Baseline data provided in the below table for each clinic including their budgeted census. GOAL: to increase census by 10% in the next quarter January-March 2012. Baseline Census Budgeted Census Milford154190 Framingham157180 Southbridge154190

3. CHANGE (Do) Office Clinic Coordinator or Nurse will contact discharged clients to invite them back to treatment. Clients will be informed of same day admission process, day and time. Began change cycle the last week in December in Milford/Framingham and the first week in January in Southbridge

4. RESULTS (Study) Review of data for the 3 months following this change indicated that 42 clients returned to treatment. Census increased at all the outpatient pilot sites from an average of 155 in December 2011 to 173 in March of 2012: a 12% increase which was higher than the original goal.

5. NEXT STEPS (Act) Plan to continue this change to re-engage clients back into treatment by making follow up calls in a timely manner. Expansion to the largest OTP clinic in March 2012 based on demonstrated success Ongoing review of census data to implement additional change cycles.

6. IMPACT (Business Case, Lessons Learned) This change helped increased the overall client census by 12%, a difference of 55 clients. In addition to the impact on client’s lives and the community, this results in an increase in clinic revenue. Based on an estimated $4,700 in revenue per client annually this increase of 55 clients = $258,500 in annual revenue. It was clear that reaching out to clients who were discharged or dropped out is a way to reengage clients in their recovery.