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Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality
Author(s) -
Fields Dail,
Roman Paul M.,
Blum Terry C.
Publication year - 2012
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2011.01352.x
Subject(s) - total quality management , quality management , process management , quality (philosophy) , medicine , operations management , resource (disambiguation) , business , nursing , management system , computer science , engineering , computer network , philosophy , epistemology , lean manufacturing
Objective To examine the relationships among general management systems, patient‐focused quality management/continuous process improvement ( TQM / CPI ) processes, resource availability, and multiple dimensions of substance use disorder ( SUD ) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the N ational T reatment C enter S tudy ( NTCS ). Study Design The design was a cross‐sectional field study using latent variable structural equation models. The key variables are management practices, TQM /continuous quality improvement ( CQI ) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient‐focused TQM / CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM / CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient‐focused practices and protocols inherent to TQM / CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient‐focused TQM / CPI practices and have more impact when greater amounts of supporting resources are present.