One area in the treatment continuum that often proves to be problematic is the system by which a client is transferred between levels of care: the “handoff”. Any number of things that may go wrong during the handoff can be disruptive to the client's treatment and can contribute to dropouts. In this sense, the handoff process is part of the NIATx aim of increasing continuation.
What happens when a person first calls your agency for help? Does a live person answer the phone, or is the caller directed through an endless cycle of automated prompts? The caller might talk first to a receptionist, who then might hand off the call to somebody else, who then might invite the caller to leave a voicemail message. How many different people does a client meet with during a first intake appointment? How many forms does the client have to complete during the appointment - forms that request the same information multiple times? Every transition from one level of care to the next in addiction treatment is a handoff that presents a potential interruption or even an end to the client's recovery journey.
Think about a system outside the treatment field where handoffs are smooth and efficient. Maybe it's the pit crew of a champion in a NASCAR race or the passing of a baton between Olympic relay racers. What makes them so good? How can you learn what makes them so good and use those ideas in client care transitions?
NIATx has several resources to help you with handoffs. Check out the Increasing Continuation Between Levels of Care promising practices on the NIATx web site. And make sure to read the article “Don’t Fumble the Treatment Handoff” in Addiction Professional magazine.
Indeed, handoffs are so, so vital. Every hand-off sets up the opportunity for a fumble, a slip, a confused, hurried, and sometimes poorly executed transition. Looking at how other businesses, agencies, or service providers handle hand-offs is an excellent direction to take.
ReplyDeleteHere in Massachusetts we have had some exciting successes around continuation. Several programs have conducted question and answer sessions with continuing clients or current clients, seeking to determine roadblocks to continuation. Using the nominal group technique, programs have undertaken new initiatives around keeping clients retained in treatment from one level of care to the next.
One program used staff education to improve the level of client retention. Too often, they found, staff at one level of care didn't REALLY know the details of the next level of care. With site visits by staff, with handouts and written material, staff members were helped to be better informed. They then were able to more fully, positively, and accurately present information to clients about the next level of care. The results - nice improvements in retention.