Quantitative data collected for this study included structured ratings of correctional agency offender case plans and surveys of members of the LCT and other organizational staff in the participating agencies. These dimensions included: 1 Measurement the problem or service needs assessed by a given agency ; 2 Integration with the Case Plan the degree to which the case plan targets needs identified ; 3 Conveyance evidence that the case plan was shared with the community based treatment provider ; and 4 Services Activation evidence that the community-based treatment provider delivered services in accordance with the needs identified in the case plan.
In each period, research staff randomly selected five case plans per month from agency records and rated them using the ART-RF. Case plans from the Delayed-Start sites were rated during the same period of time as for the Early-Start sites. Composite scores for each of the four quality dimensions were calculated for the five cases sampled each month, generating four ratings Measurement, Integration, Conveyance, and Services Activation per month.
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There are different versions of the BSOC, with item wording tailored to the type of respondent: treatment staff, correctional staff, treatment director, and correctional director. In addition, treatment executive and correctional executive versions of the BSOC collected data on number of staff, staff turnover, types of services provided, admissions, caseload, and budget.
To assess costs of the intervention, members of the LCT were asked to report monthly on the number of hours they spent on LCT activities. Respondent interviews were valuable to understand and clarify the experiences, motivations, and underlying attitudes of participants involved in change projects Tracy These interviews were particularly useful for identifying unanticipated factors that affected the success of the change process. Interviews were conducted by members of each research center, either in person or over the phone.
Interviews were audio recorded, transcribed, fact-checked, stripped of identifying information, and then analyzed using a multi-part group and individual coding process. The primary hypotheses of the study are that enhancements or improvements in each of the following outcomes occur only after the introduction of a specific and structured process improvement initiative OPII :.
The percentage of case plans forwarded from correctional agencies to community treatment programs. The level of the use of case plans by community-based substance abuse treatment programs. Secondary hypotheses are concerned with factors affecting the degree of success that LCTs experienced in achieving the goals they established for themselves. The implementation questions for the OPII study include: 1 How are implementation outcomes related to variations across states in system characteristics, configurations of LCTs, assessment processes, and study implementation?
Informed consent was obtained by research participants, including staff and managers of participating agencies, at varying points of time throughout the study, depending upon data collection requirements. Baseline structured staff surveys and corresponding participant consent were administered at the time of the kick off meeting of the early start site for participants of both the Early-Start and Delayed-Start sites.
Qualitative interviews occurred after the randomization. ART-RF case ratings samples began six months prior to randomization; since the ratings did not collect personal identifying information, but rather agency documentation patterns, offender consent was not required. The organizational intervention under study in this paper will extend the use of interagency LCTs and externally facilitated organizational coaching to enhance the shared processes of assessment, case planning, service referral, and treatment provision processes between correctional agencies and community based treatment agencies.
This study will generate and extend knowledge related to the science of implementation and organizational change in at least four key areas.
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First, the study will provide some of the first evidence of the effectiveness of change teams and facilitated coaching strategies to bring about changes in organizational processes specifically assessment and case planning within correctional systems. While the utilization of organizational coaching and facilitation has been recognized as an effective organizational change process in correctional systems National Institute of Corrections , scant empirical evidence exists of its impact in promoting adoption and implementation of evidence-supported practice.
Second, the application of organizational change strategies such as change teams, and process improvement initiatives, such as NIATx, typically target change processes within a single organization. The interagency contexts of this study, coupled with the divergence in organizational culture between correctional and treatment settings, provide unique context within which to study the complexities of bringing about enhancements in the delivery of evidence-supported client level interventions.
Third, this study provides a highly structured and rigorous approach to ensuring and documenting the fidelity of the facilitated intervention, including the development of a facilitation intervention manual and learning circles among the facilitators. These enhancements introduce significant opportunities to better understand the nature and quality of effective organizational facilitation.
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Fourth, this study extends methodological approaches to the inquiry of implementation and organizational improvement in a number of ways. As noted, the use of non-validated instrumentation, most notably in the case file review process ART-RF , but also nearly all of the survey measures, present major risks and challenges to the analysis and interpretation processes.
Nonetheless, the focused efforts at construct triangulation, drawing upon multi-methods data collection survey, chart abstraction, qualitative interviews provide the potential for advancing measurement sophistication in this nascent field of inquiry. The reflective nature of our intervention design, one in which the speed at which the LCTs progress through the planned phases of the intervention, as well as the targeting of the process improvement goals selected by each LCT, present significant risks and challenges to analysis and interpretation.
Finally, given the local setting context within which these LCTs are formed, the potential for spillover or generalization effects between early start and local start sites is an area for concern. For each of these methodological risks and liabilities, we have taken efforts to anticipate and guard against the most egregious risks, and we hope, in the process, to make significant contribution to the study of organizational improvement and implementation in general and within the unique context of correctional settings in particular.
Fletcher Bethesda, MD.
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This study was funded under a cooperative agreement from the U. Competing interests. All authors read and approved the final manuscript. Michael S Shafer, Email: ude.
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Michael Prendergast, Email: ude. Gerald Melnick, Email: ude.
Lynda A Stein, Email: ude. Wayne N Welsh, Email: ude. National Center for Biotechnology Information , U.
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Journal List Health Justice v. Health Justice. Published online Jan 8. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Jul 19; Accepted Oct This article is published under license to BioMed Central Ltd. This article has been cited by other articles in PMC.
Abstract Background The Organizational Process Improvement Intervention OPII , conducted by the NIDA-funded Criminal Justice Drug Abuse Treatment Studies consortium of nine research centers, examined an organizational intervention to improve the processes used in correctional settings to assess substance abusing offenders, develop case plans, transfer this information to community-based treatment agencies, and monitor the services provided by these community based treatment agencies. Discussion Providing substance abuse offenders with coordinated treatment and access to community-based services is critical to reducing offender recidivism.
Electronic supplementary material The online version of this article doi Keywords: Correctional treatment systems, Assessment, Case planning, Change teams, Facilitators, Multi-site cluster randomized design. Background Screening and assessment are clinical processes used to detect and then determine the extent, pervasiveness, or severity of presenting problems or issues by patients in a variety of health and other service settings. Aims and objectives The aim of this study is to test an interagency implementation strategy in linked correctional and community-based treatment systems to improve the assessment and case planning processes that these agencies and their staff perform as they coordinate substance abuse treatment and services for offenders transitioning between these two systems.
Significance The social significance of this study lies in its context within criminal justice systems and its focus on the processes of offender assessment and case referral, an interagency juncture long recognized to be faulty and ill-devised Taxman, Cropsey et al. Table 1 Core dimensions of the assessment continuum. Measurement and instrumentation This dimension is concerned with the breadth and quality of instruments that a correctional agency uses to identify the strengths, weaknesses, and service needs of substance-using offenders.
Nine domains have been identified as being fundamental to a high quality assessment of offenders with substance use disorders: 1.
History and patterns of substance abuse 2. History of and engagement in drug treatment 3. Motivation for treatment 4. History of mental illness 5.
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Typical examples of improvements include reducing costs, reducing execution times and reducing error rates. For example, if your company has an e-store, to improve the purchasing process one has to look how different components like billing, paying and transport impact each other, and how cost efficient the whole operation is when combined.
In other words, BPM acts as the bridge between business operations and IT systems, and allows us to understand how IT systems contribute to adding value to the organisation by streamlining its work practices.