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NIATx was developed under the leadership of Dr. David Gustafson along with the Robert Wood Johnson Foundation, National Institute of Drug Abuse and others to improve treatment and recovery outcomes through process improvement. NIATx operates out of the Center for Health Enhancement System Studies at the University of Wisconsin-Madison, College of Engineering. The Ohio Department of Alcohol and Drug Addiction Services began working with NIATx in October 2006 when it was awarded a federal grant referred to as “Strengthening Treatment Access and Retention-State Implementation” (STAR-SI) to increase access and retention in treatment. Today, the Ohio Department of Mental Health and Addiction Services continues to diffuse the NIATx model of process improvement with prevention agencies and programs.

Process improvement is defined by NIATx as a set of coordinated activities to continually improve the effectiveness and efficiency of organizations’ ability to meet their missions. Processes need to be planned and managed to get desired results since 85 percent of customer-related problems are process related -- not people problems. The NIATx model allows for changes to be made and tested before adopting, adapting, or abandoning the changes, one change at a time. This embeds a culture of quality within the organization, promotes an understanding of customers, encourages group problem-solving and data-informed decision making

Why NIATx? When the focus is on cost, costs will go up. When the focus is on quality, costs will go down. NIATx is a quick, simple and almost costless way to focus on quality through process improvement. Using the five key principles of NIATx, efficiency, effectiveness, outcomes, customer satisfaction, staff morale, productivity and staff retention, both the organizational climate and the financial bottom line improve through incremental change over time using existing resources at little or no cost.

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Treatment Goal and AIMS


  • To increase access and retention


  • Reduce waiting times
  • Reduce no-shows
  • Increase admissions
  • Increase continuation
Access and Retention Treatment Measures

access treatment measures

Program Measures

(aggregate data)
  • Number of admissions* per month
  • Average number of units of service** within 30 days of admission

Process Improvement Measures

(client data)
  • Time from 1st contact to admission
  • Time from admission to 1st clinical encounter
  • Time from the 1st to 2nd clinical encounter
  • Number of clients who request services and receive an assessment
  • Number of clients who receive an assessment and are admitted***
  • Number of clients who proceed from admission to succeeding units of service, i.e. 4 sessions within 30 days of admission
*Admission= first date of an assessment
**Units of service = based on the number of days clients received a clinical service (does not include assessment or case management.NOTE: Multiple services on the same day are counted as one day.
***Admitted=1st clinical encounter (does not include assessment or case management)
Prevention Goal & AIMS


  • To increase efficiency, effectiveness and sustainability


  • Increase capacity for services and programming
  • Increase the use of evidence-based policies, programs, practices and strategies
  • Increase performance management
  • Increase staff retention
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Key Principles