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Inspiring change leaders

October 1, 2006
by MAUREEN FITZGERALD and ALLY EVANS
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NIATx's Change Leader Academy aims to help develop leaders to promote process improvements

Professionals in the addiction treatment field face a range of daily challenges: Clients in crises, who sometimes do not get well. Burdensome paperwork. Limited resources and crowded facilities. A complicated network of rules and regulations. Long, stressful hours in exchange for sometimes just an average salary.

Nevertheless, addiction treatment professionals enter the field aware of these challenges. “I chose this career because I wanted to be in a helping profession,” says Angie Maldonado, program evaluator at the Center for Drug-Free Living in Florida. “The intrinsic rewards are what motivate me. There's nothing more fulfilling for me than helping the clients we serve reclaim their lives.”

Maldonado has been with the CFDFL for ten years (her entire professional career). Like many other committed professionals in addiction treatment, she has worked in a variety of roles and has gained leadership skills while immersed in the daily pressures of serving a challenging population. To increase her skills and knowledge, she has completed a graduate degree while working full time. The biggest hurdle she has had to overcome in becoming a leader, says Maldonado, has been resistance to change—not only in her organization, but in the field overall.

Eda Davenport, senior director of outpatient services at Palladia in New York City, also chose her field because of her passion for helping people. Davenport is a career professional with 17 years of experience, working primarily with clients with chemical dependency and mental illness. Her initial experience as a counselor fueled her desire to pursue a master's degree in social work along with additional postgraduate training. In her roles at Palladia, Davenport works to ensure that clients receive needed services. She shares Maldonado's view on professional growth in the field, saying, “In behavioral health there has been opposition to change, and this presents a real challenge to growth and leadership.”

The CFDFL and Palladia are both members of the Network for the Improvement of Addiction Treatment (NIATx). A partnership between the Robert Wood Johnson Foundation, SAMHSA's Center for Substance Abuse Treatment, and a number of independent addiction treatment organizations, NIATx works with addiction treatment providers to make more efficient use of their capacity, improve treatment access and retention, and help staff develop leadership skills.

In March, Maldonado and Davenport attended the NIATx Change Leader Academy (CLA), a training opportunity offered to NIATx members. The academy's first session offered in-depth training in process improvement, along with networking, to almost 50 behavioral health professionals from across the country. Participants reconvened to share their experiences with process improvement at another CLA in September.

NIATx Knowledge Development Coordinator Ally Evans created the CLA with Process Improvement Coach Eldon Edmundson and NIATx Deputy Director Todd Molfenter to transform committed learners into committed leaders of change in behavioral healthcare organizations. The presence of a powerful and effective change leader in an organization is one of the key principles of successful change that guides NIATx's work (sidebar). The CLA puts this principle into action while offering a professional growth opportunity that promotes workforce development.

In developing the CLA, NIATx distributed a change leader characteristic survey to NIATx executive sponsors, change leaders, and change team members. Survey results indicated that the most successful change leaders are perceived as being persistent, respected within the organization, challenging the status quo, achieving data-verifiable results, and focusing the team on objectives.

The survey results helped NIATx develop the program content, as well as a change leader self-assessment evaluation that participants completed at the March session and retook six months later to compare the results.

Instructors Evans, Edmundson, and Molfenter used a standardized skills-building and support model that combined a theoretical and experiential approach. Participants received in-depth training on process improvement concepts that they might have been using in their organizations—without formal training.

“The academy was a real eye-opener,” says Maldonado. “Even though I had been involved in implementing the NIATx model at the Center for Drug-Free Living, I had not had an intensive workshop on ‘process improvement 101’ like the one that the academy offered. Lightbulbs went off—I saw how I could implement process improvement in so many other ways at my organization.”

A key component of the NIATx process improvement model is the Plan-Do-Study-Act Cycle. Each part of the PDSA Cycle has a specific purpose:

  • Plan. Identify the aim of the change and predict which results will make the change a real improvement.

  • Do. Try the change for a short period (two weeks) and in a limited area (for a few patients).

  • Study. Complete the data analysis, comparing predicted results with actual results.

  • Act. Use the results of the Study stage to decide the next steps.

At the March session, participants completed the Plan step. They received guidance on how to complete the Do step in the following six months. By leading a new change project in their organizations, they applied the skills they learned at the academy. Participants continually networked with their peers and experts via e-mail, telephone, and blogs. This “Learn-Do-Share” approach provides the right balance of education, experience, and networking that is a key part of NIATx's leadership development process.

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