The authors analyze the pilot implementation of a statewide automated outcome monitoring system (OMS) in California, using the perspectives of substance abuse treatment providers responsible for its day-to-day operation. To gain a better understanding of changes experienced by staff and their perceptions of barriers and facilitators of implementation, they conducted 28 focus groups designed to inform midstream adjustments to the system prior to its possible roll-out. Qualitative analysis of the focus group data revealed five important factors influencing implementation: the treatment provider's ethos, the time-consuming nature of the OMS, staff buy-in, resources, and counselor and program discretion. Lessons learned underscored the importance of taking into consideration aspects of organizational change and institutional resources and infrastructure when implementing a major change such as an automated OMS. Findings might be useful to those designing and implementing similar systems or other large organizational change initiatives.
Backer, T. E. (2000). The failure of success: Challenges of disseminating effective substance abuse prevention programs. Journal of Community Psychology, 28(3), 363-373.
2.
Backer, T. E., David, S. L.,& Saucy, G. (Eds.). (1995). Reviewing the behavioral science knowledge base on technology transfer(NIDA Research Monograph No. 155). Rockville, MD: National Institute on Drug Abuse.
3.
Backer, T. E., Liberman, R. P., & Kuehnel, T. G. (1986). Dissemination and adoption of innovative psychosocial interventions. Journal of Consulting and Clinical Psychology, 54(1), 111-118.
4.
Bridges, W. (1991). Managing transitions: Making the most of change. Menlo Park, CA: Addison-Wesley.
5.
Brown, T. G., Topp, J.,& Ross, D. (2003). Rationales, obstacles and strategies for local outcome monitoring systems in substance abuse treatment settings. Journal of Substance Abuse Treatment, 20, 31-42.
6.
Camp, J. M., Krakow, M., McCarty, D., & Argeriou, M. (1992). Substance abuse treatment management information systems: Balancing federal, state, and service provider needs. Journal of Mental Health Administration, 19(1), 5-20.
7.
Carise, D., Cornely, W., & Gurel, O. (2002). A successful researcher-practitioner collaboration in substance abuse treatment. Journal of Substance Abuse Treatment, 23, 157-162.
8.
Coffey, R. A., Mark, T., King, E., Harwood, H., McKusick, D., Genuardi, J., et al. (2001). National estimates of expenditures for substance abuse treatment, 1997. Rockville, MD: U.S. Department of Health and HumanServices, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT).
9.
Commission on California State Government Organization and Economy (Little Hoover Commission). (2003). For our health & safety: Joining forces to defeat addiction. Sacramento, CA: Little Hoover Commission.
10.
D’Aunno, T. (1997). Linking substance abuse treatment and primary health care. In J. A. Egertson, D. M. Fox, & A. I. Leshner (Eds.), Treatment drug users effectively(pp. 311-351). Malden, MA: Blackwell.
11.
D’Aunno, T., Vaughn, T. E., & McElroy, P. (1999). An institutional analysis of HIV prevention efforts by the nation's outpatient drug abuse treatment units. Journal of Health and Social Behavior, 40, 175-192.
12.
Denzin, N. K. (1970). The research act: A theoretical introduction to sociological methods. Chicago: Aldine.
13.
Department of Health and Human Services, Substance Abuse and Mental Health Services Administration(SAMHSA)TOPPSII Steering Committee. (n.d.). Treatment Outcomes and Performance Pilot Studies enhancement (TOPPS II) grantees meeting—October 30-31, 2000 (State reports: Problems and successes with TOPPS II). Retrieved October 17, 2001, from http://www.samhsa.gov/centers/csat/content/topps2/oct2000_statereports.htm
14.
Diamond, M. A. (1995). Organizational change as human process, not technique. In T. E. Backer, S. L. David,& G. Saucy (Eds.), Reviewing the behavioral science knowledge base on technology transfer(NIDA Monograph No. 155, pp. 119-131). Rockville, MD: National Institute on Drug Abuse.
15.
Evans, E.,& Hser, Y. (2004). Pilot-testing a statewide outcome monitoring system: Overviewof the CaliforniaTreatmentOutcome Project (CalTOP). Journal of Psychoactive Drugs, 35(SARCSuppl. 2), 109-114.
16.
Galanter, M., Keller, D. S., Dermatis, H., & Egelko, S. (2000). The impact of managed care on substance abuse treatment: Areport of the American Society of Addiction Medicine (ASAM). Journal of Addictive Diseases, 19(3), 13-34.
17.
Galvin, D. E. (n.d.). CARF special report: Accreditation as an accountability strategy. Retrieved December 12, 2001, from http://www.carf.org/SpecReport/Introduction.htm
18.
Gray, B. (1989). Collaborating: Finding commonground for multiparty problems. San Francisco: Jossey-Bass.
19.
Harrison, P. A.,& Asche, S. E. (2001). Outcomes monitoring in Minnesota: Treatment implications, practical limitations. Journal of Substance Abuse Treatment, 21, 173-183.
20.
Hay Group. (1999). The Hay Group study: Health care plan design and cost trends (1988-1997).Retrieved July 13, 2004, from www.naphs.org/news/haygroupreport.html
21.
Hser, Y., & Anglin, M. D. (2002). Making research relevant and beyond: [Review of the book Bridging the gap between practice and research: Forging partnerships with community-based drug and alcohol treatment]. Contemporary Psychology, 47, 75-78.
22.
Hser, Y. I., Evans, E., Teruya, C., Ettner, S., Hardy, M., Urada, D., et al. (2002). The California Treatment Outcome Project (CalTOP) final report. Unpublished report, University of California, Los Angeles, Integrated Substance Abuse Programs.
23.
Klein, K. F., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055-1080.
24.
Lamb, S., Greenlick, M. R.,& McCarty, D. (1998). Bridging the gap between practice and research: Forging partnerships with community-based drug and alcohol treatment. Washington, DC: NationalAcademyPress.
25.
Liddle, H. A., Rowe, C. L., Quille, T. J., Dakof, G. A., Mills, D. S., Sakran, E., et al. (2002). Transporting a research-basedadolescent drugtreatment intopractice. Journal of Substance AbuseTreatment, 22, 231-243.
26.
Marsden, M. E. (1998). Organizational structures and the environmental context of drug abuse treatment: Issue paper. Retrieved October 12, 2001, from http://165.112.78.61/HSR/da-tre/MarsdenOrg.html
27.
Marshall, C.,& Rossman, G. B. (1995). Designing qualitative research(2nd ed.). ThousandOaks, CA: Sage.
28.
McCarty, D., McGuire, R. G., Harwood, H. J.,& Field, T. (1998). Using state information systems for drug abuse services research. American Behavioral Scientist, 41, 1090-1106.
29.
McLellan, A. T., Carise, D., & Kleber, H. D. (2003). Can the national addiction treatment infrastructure support the public's demand for quality care?Journal of Substance Abuse Treatment, 25, 117-121.
30.
McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9, 199-213.
31.
McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Diseases, 168(1), 26-33.
32.
Patton, M. Q. (1990). Qualitative research and evaluation methods(2nd ed.). Newbury Park, CA: Sage.
33.
Rogers, E. M. (1995) Diffusion of innovation(4th ed.). New York: Free Press.
34.
Schein, E. H. (1992). Organizational culture and leadership(2nd ed.). San Francisco: Jossey-Bass.
35.
Shedlin, M. G., & Schreiber, J. M. (1995). Using focus groups in drug abuse and HIV/AIDS research. In E. Y. Lambert, R. S. Ashery, & R. H. Needle (Eds.), Qualitative methods in drug abuse and HIV research(NIDAResearchMonograph No. 157, pp. 136-155). Rockville, MD: National Institute onDrugAbuse.
36.
Torrey, W. C., Drake, R. E., Cohen, M., Fox, L. B., Lynde, D., Gorman, P., et al. (2002). The challenge of implementing and sustaining integrated dual diagnosis treatment programs. Community Mental Health Journal, 38(6), 507-521.
37.
Weisner, C., McCarty, D.,& Schmidt, L. (1999). Newdirections in alcohol and drug treatment under managed care [Special issue]. American Journal of Managed Care, 5, SP57-SP69.
38.
Zweben, J. E., Cohen, J. B., Obert, J., Vandersloot, D., & Marinelli-Casey, P. (2000). Conducting trials in community settings: The provider perspective. Journal of Psychoactive Drugs, 32(2), 193-199.
