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Implementation of Network for the Improvement of Addiction Treatment (NIATx) Processes in Substance Use Disorder Treatment Centers

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Abstract

Internal process improvements embedded within the Network for Improvement of Addiction Treatment (NIATx) program are promising innovations for improving substance use disorder (SUD) treatment performance, such as engagement and retention. To date, few studies have examined the variables that may increase diffusion and implementation of NIATx innovations. This study investigates organizational characteristics associated with SUD treatment center utilization of NIATx process improvements in a sample of 458 treatment programs. Overall, 19% had utilized NIATx process improvements. After statistically controlling environmental factors, five organizational variables were associated with the likelihood that treatment centers used NIATx processes. Organization size, administrative intensity, membership in a provider association, and participation in National Institute on Drug Abuse’s Clinical Trials Network were positively associated with the odds of utilizing NIATx processes, while the association for the level of slack resources was negative. The findings suggest that policies and related supportive efforts may be required to facilitate diffusion and implementation of NIATx processes to affect SUD treatment center performance and capacity.

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References

  1. Rosenberg L. Quality as the cornerstone of behavioral health: Four critical issues. Journal of Behavioral Health Services & Research 2007; 34: 353–356.

    Article  Google Scholar 

  2. Institute of Medicine. Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders: Improving the Quality of Health Care for Mental and Substance-Use Conditions. Washington: National Academy of Sciences. 2005.

    Google Scholar 

  3. Quanbeck AR, Madden L Edmundson E, et al. A business case for quality improvement in addiction treatment: Evidence from the NIATx collaborative. Journal of Behavioral Health Services & Research 2012; 39: 91–100.

    Article  Google Scholar 

  4. McCarty D, Gustafson D, Capoccia V.A. et al. Improving care for the treatment of alcohol and drug disorders. Journal of Behavioral Health Services & Research 2009; 36: 52–60.

    Article  Google Scholar 

  5. Fields D, Blum T, Roman P. Management systems, patient quality improvement, resource availability, and substance abuse treatment quality. Health Services Research 2012; 47: 1068–1090.

    Article  PubMed  Google Scholar 

  6. Fields D. & Roman P. Total quality management and performance in substance abuse treatment centers. Health Services Research 2010; 45: 1630–1650.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Herbeck DM, Gonzales R Rawson RA. Performance improvement in addiction treatment: Efforts in California Journal of Psychoactive Drugs 2010; SARC supplement 6: 261–268.

  8. Douglas TJ, Judge, W. Total quality management implementation and competitive advantage: the role of structural control and exploration. Academy of Management Journal 2001; 44: 158–169.

    Article  Google Scholar 

  9. Easton GS, Jarrell SL. The effects of total quality management on corporate performance. In: R Cole, WR Scott (Eds.) The Quality Movement and Organization Theory. Thousand Oaks: Sage 2000, pp. 89–130.

    Google Scholar 

  10. Milne SH, Blum TC, Roman PM. Quality management in a health care setting: A study of substance abuse treatment centers. Advances in the Management of Organizational Quality 2000; 5: 215248.

    Google Scholar 

  11. Shortell S, O’Brien J, Carmen J, et al. Assessing the impact of continuous quality improvement/total quality management: Concept vs. implementation. Health Services Research 1995; 30: 377–389.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. McCarty D, Gustafson DH, Wisdom JP, et al. The Network for the improvement of addiction treatment (NIATx): Enhancing access and retention. Drug and Alcohol Dependence 2007; 88: 138–145.

    Article  PubMed  Google Scholar 

  13. Hoffman KA, Green CA, Ford JA, et al. Improving quality of care in substance abuse treatment using five key process improvement principles. Journal of Behavioral Health Services & Research 2012; 39: 234–244.

    Article  Google Scholar 

  14. Gustafson D H, Quanbeck AR, Robinson JM, et al. Which elements of improvement collaboratives are most effective? A cluster-randomized trial. Addiction 2013; 108: 1145–1157.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hoffman KA, Ford JH, Choi D, et al. Replication and sustainability of improved access and retention within the network for the improvement of addiction treatment. Drug and Alcohol Dependence 2008; 98: 63–69.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Crevecoeur-MacPhail D, Bellows A, Rutkowski BA, et al. “I’ve been NIATxed”: Participants’ experience with process improvement. Journal of Psychoactive Drugs 2010; SARC supplement 6: 249–259.

  17. Brown VB, Meichior LA. Women with co-occurring disorders (COD): Treatment settings and service needs. Journal of Psychoactive Drugs 2008; SARC supplement 5: 365–376.

  18. Damschroder L, Aron D, Keith, R, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science 2009; 4: 50–64.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Venkatraman N. Strategic orientation of business enterprises: The construct, dimensionality, and measurement. Management Science 1989; 35(8), 942–962.

    Article  Google Scholar 

  20. Vera D, Crossan M. Strategic leadership and organizational learning. Academy of Management Review 2004; 29: 222–240.

    Google Scholar 

  21. Kaplan HC, Brady, PW, Dritz MC, et al. The influence of context on quality improvement success in health care: A systematic review of the literature. The Milbank Quarterly 2010; 88: 500–559.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rogers EM. Diffusion of Innovations, Fifth Edition. New York: The Free Press. 2003.

    Google Scholar 

  23. Zinn J, Flood A. Commentary: Slack resources in health care organizations - fat to be trimmed or muscle to be exercised? Health Services Research 2009; 44: 812–820.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Picone G, Sloan F, Chou S, et al. Does higher hospital cost imply higher quality of care? The Review of Economics and Statistics 2003; 85: 51–62.

    Article  Google Scholar 

  25. Greenhalgh T, Robert G, MacFarlane F, et al. Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly 2004; 82: 581–629.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Molfenter T, Capoccia V, Boyle M, et al. The readiness of addiction treatment agencies for health care reform. Substance Abuse Treatment, Prevention, and Policy 2012; 7: 16–24.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Smith DE, Lee DR, Davidson LD. Health care equality and parity for treatment of addictive disease. Journal of Psychoactive Drugs 2010; 42(2): 121–128.

    Article  PubMed  Google Scholar 

  28. McKinley W. Complexity and administrative intensity: The case of declining organizations. Administrative Science Quarterly 1987; 32: 87–105.

    Article  Google Scholar 

  29. Quanbeck A, Gustafson D, Ford J, et al. Disseminating quality improvement: Study protocol for a large cluster-randomized trial. Implementation Science 2011; 6: 44–55.

    Article  PubMed  PubMed Central  Google Scholar 

  30. McConnell KJ, Hoffman K, Quanbeck, A, et al. Management practices in substance abuse treatment programs. Journal of Substance Abuse Treatment 2009; 37: 79–89.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Savage S, Abraham A, Knudsen H, et al. Timing of buprenorphine adoption by privately funded substance abuse treatment programs: The role of institutional and resource-based interorganizational linkages. Journal of Substance Abuse Treatment 2012; 42: 16–24.

    Article  PubMed  Google Scholar 

  32. Gupta R, Pandit A. Strategic entrepreneurial orientation: Development of a multi-dimensional construct based on literature review. South Asian Journal of Management 2012; 19(4): 88–110.

    Google Scholar 

  33. Dess GG, Lumpkin GT, Covin JG. Entrepreneurial strategy making and firm performance: Tests of contingency and configurational models. Strategic Management Journal 1997; 18(9): 677–695.

    Article  Google Scholar 

  34. Chatzoglou PD, Diamantidis AD, Vraimaki E, et al. Aligning IT, strategic orientation, and organizational structure. Business Process management Journal 2011; 17(4): 663–687.

    Article  Google Scholar 

  35. Allison PD. Missing data. In: RE Milsap, A Maydeu-Olivares (Eds.) The SAGE Handbook of Quantitative Methods in Psychology. Thousand Oaks, CA: Sage, 2009, pp. 73–91.

    Google Scholar 

  36. Kumar N, Stern L, Anderson JC. Conducting interorganizational research using key informants. Academy of Management Journal, 1993; 36: 1633–1651.

    Article  Google Scholar 

  37. McCarty D, Fuller B, Kaskutas L, et al. Treatment programs in the national drug abuse treatment clinical trials network. Drug and Alcohol Dependence 2008; 92: 200–207

    Article  PubMed  Google Scholar 

  38. StataCorp. Stata Multiple Imputation Reference Manual Release 13. College Station, TX: Stata Press, 2013.

  39. Roman PM, Ducharme LJ, Knudsen HK. Patterns of organization and management in private and public substance abuse treatment programs. Journal of Substance Abuse Treatment 2006; 36: 321–334.

    Google Scholar 

  40. Institute of Medicine. Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington, DC: The National Academies Press, 2006.

    Google Scholar 

  41. SAMSHA - Substance Abuse and Mental Health Services Administration 2005. National registry of evidence-based programs and practices (NREPP). Available online at http://nrepp.samhsa.gov/. Accessed April 14, 2015.

  42. McLellan AT, Carise D, Kleber HD. Can the national addiction treatment infrastructure support the public’s demand for quality care? Journal of Substance Abuse Treatment 2003; 25: 117–121.

    Article  PubMed  Google Scholar 

  43. McLellan AT, Chalk M, Bartlett J. Outcomes, performance, and quality: What’s the difference? Journal of Substance Abuse Treatment 2007; 32: 331–340.

    Article  PubMed  Google Scholar 

  44. Ducharme LJ, Mello H, Roman, PM, et al. Service delivery in substance abuse treatment: reexamining comprehensive care. The Journal of Behavioral Health Services & Research 2007; 34: 121–136.

    Article  Google Scholar 

  45. Garnick DW, Lee MT, Horgan CM et al. Adapting Washington Circle performance measures for public sector substance abuse treatment systems. Journal of Substance Abuse Treatment 2009; 36: 265–277.

    Article  PubMed  Google Scholar 

  46. Garnick DW, Lee MT, Horgan CM et al. Lessons from five states: Public sector use of the Washington Circle performance measures. Journal of Substance Abuse Treatment 2011; 40: 241–254.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Blum TC, Fields DL, Goodman JS. Organization level determinants of women in management. Academy of Management Journal 1994; 3: 241–268.

    Article  Google Scholar 

  48. Pfeffer J, Salancik G. The External Control of Organizations. New York: Harper & Row. 1978.

    Google Scholar 

  49. DiMaggio PJ, Powell WW. The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review 1983; 48: 147–160.

    Article  Google Scholar 

  50. Buck JA. The looming expansion of treatment for substance abuse under the Affordable Care Act. Health Affairs 2010; 30: 1402–1410.

    Article  Google Scholar 

Download references

Acknowledgments

The authors gratefully acknowledge the research support of the National Institute on Drug Abuse within the National Institutes of Health (Grants R01DA14482 and R37DA013110 awarded to the University of Georgia Research Foundation). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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The authors have no conflicts of interest.

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Correspondence to Hannah K. Knudsen PhD.

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Fields, D., Knudsen, H.K. & Roman, P.M. Implementation of Network for the Improvement of Addiction Treatment (NIATx) Processes in Substance Use Disorder Treatment Centers. J Behav Health Serv Res 43, 354–365 (2016). https://doi.org/10.1007/s11414-015-9466-7

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