Introducing the Beth Introducing the Beth Israel Medical Center Israel Medical Center MMTP Change Team: MMTP Change Team: Juante Vanterpool, Change LeaderJuante Vanterpool, Change LeaderDr. Ruy TioDr. Ruy TioRobert Acorda, RNRobert Acorda, RNAna Clemente, LCSWAna Clemente, LCSWJessica Barenboim, Counselor Jessica Barenboim, Counselor Ambrose Agho, CounselorAmbrose Agho, Counselor

Our Mission: Make the Our Mission: Make the CEO Happy by Improving CEO Happy by Improving

Retention…Retention…

Improve retention through Improve retention through enhanced engagement and enhanced engagement and education during Screening education during Screening

& Intake Process& Intake Process• Restructure the overall Screening & Intake Restructure the overall Screening & Intake

process process • Continue to conduct same day admissions but Continue to conduct same day admissions but

in one designated location in one designated location • Provide consistent and uniform information to Provide consistent and uniform information to

applicantsapplicants• Keep the applicant engaged during entire Keep the applicant engaged during entire

intake process by involving various disciplines intake process by involving various disciplines • Remain cordial to applicant during intake Remain cordial to applicant during intake

process to encourage patience process to encourage patience

Implement the Enhanced Implement the Enhanced Admission ProcessAdmission Process

• Managers will conduct screening process to Managers will conduct screening process to ensure thorough assessment and ensure thorough assessment and appropriateness for treatment appropriateness for treatment

• Reinforce the 5-in-5 post admission (5 Reinforce the 5-in-5 post admission (5 disciplines in 5 days)disciplines in 5 days)

• Assign new patients to counselors within 3 daysAssign new patients to counselors within 3 days• Require new admissions to attend Early Require new admissions to attend Early

Intervention/Orientation Group within first 30 Intervention/Orientation Group within first 30 days days

• Provide new admissions with clinic specific Provide new admissions with clinic specific information cards (wallet size)information cards (wallet size)

Data & Conclusions Data & Conclusions

0

10

20

30

40

50

Pre-Change

25%

Post-Change

12%

2nd Qrt.3%

3rd QrtZero%

4th Qrt14%

Adm

Discharges

Within 30daysLTC

Pre change data reflect the following:A significant # of discharges were within 30 days of treatment (6 day avg.)A significant # of discharges were “Lost to Contact” within the 30 days Voluntary Discharges via referral for enhanced/intensified services or patient relocations impact retention rates, as does incarcerations Non-Active Medical Insurance impacted retention

Adoption of a Modified Adoption of a Modified Process with minor Process with minor

adaptationsadaptationsPost changes improved early retention by providing :

• Proper screening for appropriate placement

• Early assistance in obtaining medical insurance

• Early engagement & intervention by Inter-Disciplinary Team

• Ongoing education & information about treatment and services offered

0

10

20

30

40

50

Pre-Change25%

Post-Change12%

2nd Qrt .3% 3rd QrtZero%

4th Qrt 14%

Adm

Discharges

Within 30daysLTC

The modified admission process has been integrated and adopted in 5 Clinics. The next focus will be on improving 3-6 month retention rates. The challenge still remains to implement this process in every clinic.

Impact of ChangeImpact of Change• The patients have appeared to be more engaged in The patients have appeared to be more engaged in

the treatment processthe treatment process• Clinical staff supported the change as it assisted Clinical staff supported the change as it assisted

with decreasing duplicity of documentation with decreasing duplicity of documentation • Reports are completed in a more timely mannerReports are completed in a more timely manner• A greater need for on-site support groups have been A greater need for on-site support groups have been

developed & continues to expand developed & continues to expand • Although retention rates continue to fluctuate due Although retention rates continue to fluctuate due

to a multitude of variables, overall utilization to a multitude of variables, overall utilization remains stable remains stable

• Patients feel more 'informed', 'appreciated' and Patients feel more 'informed', 'appreciated' and 'respected' 'respected'

• Although retention was the initial focus, the change Although retention was the initial focus, the change process has been instrumental in preparing all process has been instrumental in preparing all personnel for the shift in the MMTP paradigm from personnel for the shift in the MMTP paradigm from medication assistance with opiod addiction to medication assistance with opiod addiction to providing comprehensive clinical services to the providing comprehensive clinical services to the whole personwhole person