It is the opinion of ASAP staff that the most important thing that we can do for our patients is to give them the opportunity to become completely free of illicit opioid use. ASAP can measure for compliance by reviewing urine drug screen results and checking for the percentage of urine drug screens that are positive for opioids. After reviewing all the urine drug screens that have been provided to ASAP since it has opened, ASAP staff have found that 36 out of 284 urine drug screens (13%) were positive for opioids. Of the 36 positive tests, 31 were within the first 30 days of treatment. Therefore, the positive urine drug screens were either from their admission urine test or a drug screen that occurred prior to being on a stable dose on maintenance medical therapy.
ASAP uses two metrics to measure the efficacy of services and the likelihood of successful outcomes; first, the staff tracks no-show rates for daily dosing, and secondly the staff tracks the number of required monthly counseling units completed. To date, ASAP has been able to achieve a no-show rate for daily dosing of less than 4%. Most of the no-shows for daily dosing were due to patients who have transportation issues, illness including hospitalization for other medical illnesses, and incarceration. ASAP staff have completed 100% of required monthly counseling units. ASAP staff realize that these numbers are likely to change as the patient census continues to grow. Accordingly, ASAP staff is dedicated to keeping no-show rates for both daily dosing and counselling low.
It is the goal of ASAP to admit every appropriate patient to our program within one business day of initial contact. We will achieve this by having either our medical director or a program physician on site every day that we are open. We also continue to constantly forecast what our nursing and counseling staff needs are to maintain the ability to admit patients that are appropriate for this modality of care. Of all patients with contracted insurance or self-pay, we have been able to achieve the one business day goal. ASAP will have contracts with all private and Medicaid HMOs in the area by April 1, 2019.
ASAP is aware that not all patients will wish to continue or complete treatment. However, successful patient outcomes are directly related to patient retention. ASAP’s goal is to retain as many patients as possible. ASAP is attempting to maximize retention by making accessibility to the clinic as easy as possible (see next section), having a warm and inviting waiting area with a designated children’s play area, private dosing rooms, and computerized check-in. ASAP has a private, locked patient Suggestion Box located in the waiting area. The Clinic Director reviews all patient suggestions and grievances daily and they are all addressed in the ASAP Performance Improvement Committee meetings. Furthermore, as stated above, having a physician present in the clinic daily allows for admission within one business day. The Clinic Director monitors patient census daily.
ASAP is located in Olin Center at 210 E. Olin Avenue, Madison, Wisconsin. This location was chosen for its excellent accessibility for all patients wishing treatment at our facility. The building is located adjacent to the major east-west highway traversing Madison. A bus stop is easily located directly next door heading west and directly across the street heading east. There are two designated handicapped parking stalls directly in front of the clinic, and there are an additional six designated parking spots for easy access in and out of the clinic. Furthermore, there is ample parking in the remaining parking area of Olin Center. The ASAP facility has been deliberately designed to be welcoming to individuals with disabilities. ASAP will make further accommodations for persons within this population should that ever become necessary. The entrance is continuously monitored and any patients needing assistance entering and exiting the clinic are immediately assisted. There are maps located though out the clinic depicting present location and emergency exits. There are multiple signs throughout the clinic designating no weapons allowed for patient and staff safety. Patient, employee and visitor safety is further enhanced by extensive video monitoring and staff presence inside, and directly outside, the clinic.
ASAP is conducting regular patient satisfaction surveys with every patient at two weeks after admission, six months after admission, at discharge, six months after discharge, and one year after discharge. The survey is used to gain input from patients regarding how ASAP is providing the tools and support needed to achieve meaningful recovery. Additionally, ASAP has a private, locked Suggestion Box located in the patient waiting area. All suggestions are collected daily by the ASAP Clinic Director, addressed within one business day, and reviewed monthly during the ASAP Performance Improvement Committee meeting. ASAP is using patient satisfaction surveys to gage the efficacy and effectiveness of services while guiding policy and personnel training to better serve those individuals who are seeking or are in treatment. Currently 100% of respondents agree or strongly agree that they are treated by ASAP staff with dignity and respect. 100% of respondents also agree or strongly agree that they would recommend ASAP to friends and family members who need services.