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Total quality management and performance in substance abuse treatment centers.

ABSTRACT: To examine the relationship of organizational characteristics of substance abuse treatment centers with their use of quality management practices (total quality management [TQM]) and the contribution of TQM use to a center's provision of comprehensive care and to use of evidence-based treatment practices.Data were collected from a national sample of over 700 private and public substance abuse treatment centers in the National Treatment Center Study.The design was a cross-sectional field study. The key variables were three TQM practices, the provision of comprehensive treatment services, and the implementation of evidence-based treatment practices. Numerous organizational characteristics were controlled.The data were obtained through interviews with administrative directors and clinical directors of the treatment centers in 2002-2004.In multivariate models, TQM practices were positively related to provision of comprehensive care and use of evidence-based practices. A limited set of organizational characteristics predicted the use of TQM practices.Substance abuse treatment centers' implementation of TQM processes may be positively related to the quality and cost-effectiveness of care provided.

SUBMITTER: Fields D

PROVIDER: S-EPMC2976772 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

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Total quality management and performance in substance abuse treatment centers.

Fields Dail D Roman Paul M PM

Health services research 20101201 6 Pt 1

<h4>Objective</h4>To examine the relationship of organizational characteristics of substance abuse treatment centers with their use of quality management practices (total quality management [TQM]) and the contribution of TQM use to a center's provision of comprehensive care and to use of evidence-based treatment practices.<h4>Data sources</h4>Data were collected from a national sample of over 700 private and public substance abuse treatment centers in the National Treatment Center Study.<h4>Stud ...[more]

PMID: 20698897

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Project description:BackgroundNigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3%) in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7%) and Opioids (0.7%) use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria.MethodsThe study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European Treatment Unit/Program Form (June 1997 version).ResultsAll the units completed the online questionnaire. A large proportion (48%) was located in the South-West geopolitical zone of the country. Most (58%) were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%). No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147) and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services.ConclusionsThe study revealed a dearth of substance abuse treatment units (and of funds for the available ones) in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring, funding and continuous quality improvement, the units need to be organized into a sustainable network.

Project description:Research has shown that treatments that solely addressed intimate partner violence (IPV) perpetration were not very effective in reducing IPV, possibly due to neglecting individual differences between IPV perpetrators. A large proportion of IPV perpetrators is diagnosed with co-occurring substance use disorders and it has been demonstrated that successful treatment of alcohol dependence among alcohol dependent IPV perpetrators also led to less IPV. The current study investigated the relative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) to cognitive behavioral treatment addressing substance use disorders including only one session addressing partner violence (CBT-SUD+) among patients in substance abuse treatment who repeatedly committed IPV. Substance use and IPV perpetration were primary outcome measures.Patients who entered substance abuse treatment were screened for IPV. Patients who disclosed at least 7 acts of physical IPV in the past year (N?=?52) were randomly assigned to either I-StoP or CBT-SUD+. Patients in both conditions received 16 treatment sessions. Substance use and IPV perpetration were assessed at pretreatment, halfway treatment and posttreatment in blocks of 8 weeks. Both completers and intention-to-treat (ITT) analyses were performed.Patients (completers and ITT) in both conditions significantly improved regarding substance use and IPV perpetration at posttreatment compared with pretreatment. There were no differences in outcome between conditions. Completers in both conditions almost fully abstained from IPV in 8 weeks before the end of treatment.Both I-StoP and CBT-SUD+ were effective in reducing substance use and IPV perpetration among patients in substance abuse treatment who repeatedly committed IPV and self-disclosed IPV perpetration. Since it is more cost and time-effective to implement CBT-SUD+ than I-StoP, it is suggested to treat IPV perpetrators in substance abuse treatment with CBT-SUD+.

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Total quality management and performance in substance abuse treatment centers.

Publications

Total quality management and performance in substance abuse treatment centers.

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