Process Improvement Needs in Substance Abuse Treatment: Admissions Walk-through Results

摘要

Researchers have questioned whether the addictions treatment infrastructure will be able to deliver high quality care to the large numbers of people in need. In this context, the Robert Wood Johnson Foundation (RWJF) and Center for Substance Abuse Treatment (CSAT) created a nationwide network to improve access and retention in treatment. Applicant agencies described results of an admissions process “walk-through.” This qualitative study used narrative text from 327 applications to RWJF, focusing on admissions-related problems. We developed and applied a coding scheme, then extracted themes from code-derived text. Primary themes described problems reported during treatment admissions: poor staff engagement with clients, burdensome procedures and processes, difficulties addressing the clients' complex lives and needs, and infrastructure problems. Sub-themes elucidated specific process-related problems. Though findings from our analyses are descriptive and exploratory, they suggest the value of walk-through exercises for program assessment and program-level factors that may affect treatment access and retention.