In 2006, the Institute of Medicine published Improving the Quality of Health Care for Mental and Substance-use Conditions. This book recognized the chronic nature of addictive disorders and the need for recovery-oriented, community-based systems of care to help recovering people stabilize and sustain long-term sobriety. Along with NIDA’s Principles of Drug Addiction Treatment, these publications provide a framework for designing successful aftercare support for recovery from drug and alcohol problems. We followed these guidelines closely in designing applied recovery. Throughout the LeMont Michel programming you will see how we put these guidelines into practice when we designed the LeMont Michel lifestyle.
Six aims for improving healthcare quality:
1. Safe
Quality healthcare avoids injuries to patients from the care that is intended to help them.
2. Effective
Quality healthcare provides services based on scientific knowledge to all who can benefit (avoiding underuse) and refrains from providing services to those not likely to benefit (avoiding overuse).
3. Patient-centered
Quality healthcare provides treatment that is respectful of and responsive to individual patient preferences, needs, and values and ensures that patient values guide all clinical decisions.
4. Timely
Quality healthcare reduces waits and sometimes harmful delays for both those who receive and those who give care.
5. Efficient
Quality healthcare avoids waste – including waste of ideas and energy.
6. Equitable
Quality healthcare provides treatment that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
Ten Rules to guide the redesign of healthcare:
1. Care based on continuous healing relationships
Patients should receive care whenever they need it and in many forms, not just face-to-face visits with clinicians. The health care system should be responsive at all times (24 hours a day, every day)
2. Customization based on patient needs and values
The system of care should be designed to meet the most common types of needs but have the capability to respond to individual patient choices and preferences.
3. The patient as the source of control
Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them. The health system should be able to accommodate differences in patient preferences and encourage shared decision-making.
4. Shared knowledge and the free-flow of information
Patients should have unfettered access to their own medical information and to clinical knowledge. Clinicians and patients should communicate effectively and share information.
5. Evidence-based decision-making
Patients should receive care based on the best available scientific evidence. Care should not vary illogically from clinician to clinician or from place to place.
6. Safety as a system property
Patients should be safe from injury caused by the care system. Reducing risk and ensuring safety require greater attention to systems that help prevent and mitigate errors.
The health care system should make information available to patients and their families that allows them to make informed decisions when selecting a health plan, hospital, or clinical practice, or choosing among alternative treatments. This should include information describing the system’s performance on safety, evidence-based practice, and patient satisfaction.
8. Anticipation of needs
The health system should anticipate patient needs, rather than simply reacting to events
9. Continuous decrease in waste
The health system should not waste resources or patient time
10. Cooperation among clinicians
Clinicians and institutions should actively collaborate and communicate to ensure appropriate exchange of information and coordination of care
[from: Improving the Quality of Health Care for Mental and Substance-Use Conditions. Institute of Medicine, 2006.]