Strengthening Treatment Access and Retention-Quality Improvement (STAR-QI)

(Formerly known as STAR-SI)

Key DFM Personnel

Richard L. Brown, MD, MPH - Principal Investigator
Deanne Boss, MS - STAR-QI Program Director

Collaborators

Joyce Allen, Director, WI Bureau of Mental Health and Substance Abuse Services
Michael Quirke, Program Evaluation Coordinator, Bureau of Mental Health and Substance Abuse Services

Funding

Wisconsin Department of Health Services (DHS)

Program Summary

The Wisconsin STAR-QI Program began in October 2006 as a three-year grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). The purpose of the grant was to use the Network for the Improvement of Addiction Treatment (NIATx) Quality Improvement Model to improve organizational processes at the State and treatment agency level to impact client access to and retention in outpatient substance abuse treatment services. The STAR-QI Program has been so successful, that DHS has continued to fund it through September 2013.

The STAR-QI quality improvement projects aim to:

Reduce the wait time between a client's first request for service and the first treatment session
Reduce client no-shows
Increase addiction treatment centers' admissions
Increase the treatment continuation rate between the first and fourth treatment sessions

Collecting and reporting data is central to the NIATx model. Provider agencies collect baseline data before beginning a change. During the rapid-cycle quality improvement cycle, the agency continues to collect data, which they study to determine how the change impacted services. Change Teams at the provider agencies use their data to decide whether to adopt, adapt, or abandon their change project and to decide which quality improvement projects to pursue next.

Spread and sustainability are important concepts in the NIATx model. Initially ten Provider Organizations were participants in the first grant year. As we begin our seventh year, 50+ agencies are currently participating and outreach efforts are continuing.

In the Spotlight: Beacon House

Beacon House is a non-profit organization, located in Fond du Lac, Wisconsin, providing residential and outpatient substance abuse services for women. The agency is dedicated to providing compassionate, professional help to women and women with children recovering from alcoholism and/or chemical dependency. Mary Gerlach, Executive Director, is the Strengthening Treatment Access and Retention-Quality Improvement (STAR-QI) Executive Sponsor and Change Team Leader.

During the 2011-2012 STAR-QI Program year, Beacon House chose to participate in the Electronic Health Records (EHR) Focus Area. In past years, STAR-QI providers had experienced the opportunity to apply the NIATx model to other treatment delivery issues such as reducing wait time, reducing no-shows, increasing admissions and increasing continuation. Now providers had the opportunity to apply their knowledge of the NIATx model, to complete a formal search and review effort to narrow down up to three affordable electronic scheduling, billing, charting and database systems that could potentially meet the agency’s clinical information and administrative process/data needs.

The Beacon House change team began by asking the question, “What is an electronics record system? The team proceeded with a web search and participated in the monthly STAR-QI Focus Area Provider calls to answer that question. Mary’s concern was to find a system that was affordable and could be customized to a small environment which would allow them to continue to deliver excellent service to clients in the manner Beacon House had in the past. During the monthly teleconference calls, Mary had the opportunity to ask EHR questions of fellow STAR-QI peers. Mary shared that it was very helpful to ask implementation questions of Wisconsin STAR-QI colleagues whose opinions she trusted and also represented other small agencies similar to Beacon House.

Utilizing the rapid cycles of the NIATx model and at the suggestion and assistance of the STAR-QI program, Mary and her change team wrote a generic grant proposal to request funding for equipment and software from area philanthropic foundations. Then the team reviewed many EHR vendors, choosing the Celerity system. During the sixth rapid change cycle of their change project, a proposal to purchase Celerity was prepared for the Beacon House Board of Directors. At the end of the contract year, September 2012, the Board of Directors approved the purchase of Celerity, pending receipt of donation funding. Mary and her team continued to submit grant proposals for the funding of implementing their chosen EHR system.

In December 2012, a local manufacturer toured Beacon House asking them what was on their wish list. Beacon House shared their well thought out plan to implement an EHR system and the manufacturer has since provided the funds to implement the system which has an anticipated implementation date of July.

Our current participants include:

Adams County Health & Human Services Dept
Aids Resource Center of Wisconsin
AMRI Counseling
Arbor Place
ARC Community Svcs.
Beacon House
Behavioral Health Services of Racine County
Bell Therapy
Benedict Center
Bridge Health Clinics
Brown County
Center Point Counseling
Connections Counseling
Coulee Youth
Dane County DHS
Door County
Eau Claire Metro
Family Service Madison
Family Services of NE WI
Fokus Family Services
Genesis
Hiawatha
Ho-Chunk Nation, Department of Health
Holy Family Memorial Behavioral Health
Horizon Health
Human Development Center
Jackie Nitschke
Jefferson County
Journey Mental Health Center
Kewaunee County Human Services
LaCasa de Esperanza
La Crosse County
LSS Women's Way
Mayo Clinic Health System La Crosse
Meta House
North Central Health Care
Oakwood
Omni Enrichment, Inc
Open Door Center for Change
Polk County HHS
Rock Valley Community
Rock County
St. Croix County HHS
St. Joseph's Hospital
Theda Care
Tri-County
Waukesha County HHS
Wausau Health Services
West Central WI Behavioral Health
William S. Middleton Veteran's Hospital
Wood County

To promote sustainability, the staff members at participating Treatment Agencies are trained in the principles of the NIATx Improvement Process through an annual face-to-face learning session. They also participate in monthly group provider teleconference calls to support and promote continued rapid cycling quality improvement projects and network with other providers. 1:1 coaching calls are an additional option in an effort to support the quality improvement practices providers are implementing.

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