The Canyon at Peace Park

Introduction

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Patient satisfaction is an important element in measuring the effectiveness of treatment and organizational commitment to patient-centered care. Patient-centered care is a model in which patients and their families partner with health care providers to identify and treat the full range of patient needs and preferences. Organizations focusing on patient-centered care improve clinical outcomes and satisfaction rates by increasing the quality of patient-provider relationships (Rickert, 2012).

Foundations Recovery Network (FRN) employs patient-centered care to support our purpose: “Creating lifetime relationships for long term recovery.” All patients participating in treatment at The Canyon at Peace Park are offered the opportunity to provide feedback by completing patient satisfaction surveys dealing with key program processes, including their admission experience and the treatment process. This paper discusses the results of those surveys and their importance to The Canyon’s commitment to quality treatment and patient-centered care.

Patient Motivation, Engagement and Satisfaction

Treatment centers that offer flexible approaches to meet patients’ lifestyle needs and also provide evidence-based methods of care that are efficient and effectively delivered can lower relapse rates and improve patient retention (Battjes, Onken, & Delany, 1999). Patient-centered care is key in the facility’s ability to offer individualized treatment, and patient satisfaction surveys direct these efforts. Also, treatment centers that involve patients from the very beginning see longer treatment stays and more positive recovery outcomes. Patients who are highly motivated may be twice as likely to have positive outcomes on drug and alcohol use and reduced criminal involvement. Getting involved at intake and staying involved in the first stages of treatment make a significant difference in post-treatment success (Simpson, Joe, & Rowan-Szal, 1997). Patients who are satisfied with their treatment programs and receive an adequate number of services are more likely to complete treatment or stay in treatment longer. Longer treatment stays produce many positive lifestyle changes, such as long-term sobriety, lack of involvement in criminal activity and community involvement (Hser, Evans, Huang, & Anglin, 2004).

At The Canyon at Peace Park, every patient goes through a customized care plan that includes behavioral therapy, such as Cognitive Behavioral Therapy, Dialectical Behavior Therapy skills and Motivational Interviewing. Other therapeutic amenities include organic meals, yoga classes and massage therapy, hiking trips in Zuma Canyon, walks on Malibu beach, adventure therapy, a ropes course, equine therapy, a therapeutic sweat lodge and a meditation dome. Well-designed and thoughtfully managed activities keep patients satisfied and motivated. Since the facility specializes in caring for patients with co-occurring addiction and mental health conditions, these added services meet the greater needs of a patient population with more challenging psychiatric symptoms (Boden & Moos, 2009).

The Research

This paper discusses patient survey results based on data collected from more than 70% of patients treated at The Canyon. Data shared in this report offer insights into a rarely researched population—patients at private, for-profit residential facilities. Since most research is conducted in public facilities, the research offered here provides new insight.

In 2008, Rob Waggener, CEO of FRN, asked the senior management team to read the book If Disney Ran Your Hospital by Fred Lee. This exercise initiated a three-year process to improve patient-centered care through using dozens of focus groups, which included asking for input from callers who did not seek treatment, patients, referrers, alumni, families and employees. The result culminated in the development of training curriculum for staff, new patient and family workbooks, and engagement surveys throughout our system. This effort also motivated staff on every level, reducing turnover rates and making staff members feel more engaged.

Research shows that if one can close the gap between a therapist’s perception of engagement and the patient’s true level of engagement, patients’ recovery outcomes improve significantly. This premise applies to all other aspects of programs as well.

Scientific evidence says that the actual intervention technique (DBT, MI, CBT, etc.) accounts for only 15% of the treatment outcome. Fifteen percent is the same impact as placebo, hope and expectancy (Miller, et al., 2005; Quimette, et al., 1997; and Tonigan, et al., 2003).

Patient engagement chart

What matters are relationships and extra-therapeutic variables. Therapeutic alliance is a strong predictor of outcomes and retention (Barber, et al., 2001). Those patients who were more satisfied with their improvement were also more compliant with treatment recommendations (Hirsh, et al., 2005). DiClemente (et al, 2004) says that “properly incorporating the concepts of readiness and the stages of change into addiction treatment enables providers to address the diverse needs of substance abusers and treatment seekers.” Miller and Rollnick (2013) say that “having even one person who can work with clients in this [MI] person-centered way may make a difference.”

At Foundations Recovery Network, all staff are trained in Motivational Interviewing—all staff, at every facility. Here are some other factors that we incorporate into our process to improve patient-centered care:

  • Clinical staff are licensed or licensed-eligible. Our directors are master’s and PhD level.
  • We use a multi-disciplinary approach to treatment.
  • We provide ongoing internal education programs.

Our Research: Admission Experience at The Canyon

Patients at The Canyon at Peace Park highly rate their overall experience at the facility. More than half of patients give the admission experience the highest “very good” rating year over year, and more than 88% of patients said the experience was “very good” to “good” in 2013. Admission surveys evaluate three aspects of the intake process: preadmission, greeting and admission. Survey questions about admissions—an integral part of preparing patients for treatment—cover the following areas:

  • Preadmission – Questions ask patients to evaluate the accuracy of the information provided about the facility and service, as well as information about items to bring and what to expect on arrival; service aspects are evaluated, including professionalism and timeliness.
  • Greeting – Questions ask about professionalism during patient pick-up and drop-off at the facility and how comfortable staff members make the patient feel on arrival.
  • Admission – Questions again ask about professionalism with handling patient belongings and medical assessments, as well as questions about the admission process, introductions to staff members, explanations of policies and explanations, tour of the facility, efforts to orient the patient and actions that made the transition smooth.

The Canyon’s consistently high ratings for its admissions process are a sign that patients enter treatment with a positive outlook that carries through to the initial phases of treatment (see chart below).

Overall satisfaction with The Canyon's admission process

Source: Foundations Recovery Network, The Canyon at Peace Park (Malibu, Calif.)

Our Research: Treatment Experience and Patient Satisfaction Rates at The Canyon

The satisfaction scale used and developed by Foundations Recovery Network collects data on all aspects of the participants’ experience of treatment. The 36 item scale was developed internally through patient, family and staff focus groups, community outreach, and an extensive process that combined items from existing instruments and accreditation standards. Individuals record their satisfaction on a five-point scale of “poor” to “excellent.” There are two items measuring global satisfaction. One addresses “overall satisfaction” and the second asks the patient if he or she would recommend treatment at that particular center to others. The instrument is currently under study by the research team at FRN, and publication is expected in 2014.

Ratings of services are generally high at The Canyon as well. Exit surveys ask about several aspects of care, revealing patient perceptions of key areas. Patient responses indicated strong levels of satisfaction with the facility’s ancillary services, which include hiking trips, special meditation areas and adventure therapy. High ratings for clinical experience and medical and psychological services closely follow ancillary services. The staff also receive high ratings for their professionalism. The average ratings for 2013 demonstrate a consistently high level of service across the facility (see chart below).

The Canyon 2013 Satisfaction Scale Scores

Source: Foundations Recovery Network, The Canyon at Peace Park (Malibu, Calif.)

Our Research: Overall Satisfaction

Patient responses to questions about overall satisfaction and initial impression also show high levels of confidence with The Canyon at Peace Park and staff members. On a scale from 1 to 5, the facility received the following average ratings for 2013:

2013 The Canyon Initial Impression and Overall Satisfaction

Source: Foundations Recovery Network, The Canyon at Peace Park (Malibu, Calif.)

Our Research: Patient Recommendation Scores

A patient’s inclination to recommend a facility to others indicates confidence in the treatment program and a strong belief in its worth to others. Patients who recommend The Canyon to others are willing to put their reputations at risk with friends and family. A person who recommends a treatment facility to others is making a stronger statement than a person who says he or she is satisfied with a facility’s service (Reichheld, 2003).

Over 90% of The Canyon’s patients responded to the question, “Would you recommend The Canyon?” with “agree” or “strongly agree” responses (see chart below).

2013 The Canyon and recommendations

Source: Foundations Recovery Network, The Canyon at Peace Park (Malibu, Calif.)

Conclusion

The Canyon at Peace Park offers patients a serene setting with caring staff members and engaging services. The facility successfully creates an environment that encourages patient engagement and therefore offers the best possibilities of positive long-term outcomes

Foundations Recovery Network is committed to research that improves treatment for all addicted individuals. If you would like to speak with an admissions coordinator today or if you would like to learn more about our research methods and programs, please visit us online at https://www.foundationsrecoverynetwork.com or call us directly at 877-714-1318.

References

Barber, J.P., Luborosky, L., Gallop, R., Crits-Christoph, P., Frank, A., Weiss, R.D. and Thase, M.E. (2001). “Therapeutic Alliance as a Predictor of Outcome and Retention in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study.” Journal of Consulting and Clinical Psychology 69(1). Pp 119-124.

Battjes, R. J., Onken, L. S., & Delany, P. J. (1999). Drug abuse treatment entry and engagement: Report on a meeting on treatment readiness. Journal of Clinical Psychology, 55 (5), 643-657.

Boden, M. T., & Moos, R. (2009). Dually diagnosed patients’ responses to substance use disorder treatment. Journal of Substance Abuse Treatment. 37 (4), 335-345.

DiClemente, C.C., Schlundt, D.,and Gemmell, L. (2004). “Readiness and Stages of Change in Addiction Treatment.” The American Journal on Addictions, 13:103-119. Retrieved from http://informahealthcare.com/doi/abs/10.1080/10550490490435777 on May 3, 2013.

Hser, Y.-I., Evans, E., Huang, D., & Anglin, D. M. (2004). Relationship between drug treatment services, retention and outcomes. Psychiatric Services, 55 (7), 767-774.

Hirsh, A.T., Atchison, J.W., Berger, J. J., Waxenberg, L. B., Lafayette-Lucey, A.. Bulcourf, B.B., and Robinson, M.E. (2005). “Patient Satisfaction With Treatment for Chronic Pain: Predictors and Relationship to Compliance.” Clinical Journal of Pain 21(4). Pp. 302-310.

Miller, S.D., Lee, M.L., Plum, W. and Hubble, M.A. (2005). “Making Treatment Count: Client-Directed, Outcome-Informed Clinical Work with Problem Drinkers.” Retrieved from http://scottdmiller.com/wp- content/uploads/Making%20Treatment%20 Count%20(Lewbow).pdf on May 5, 2013.

Miller, W.R. & Rollnick, S. (2013). Motivational Interviewing: Helping People Change, 3rd Edition. Guilford Press. New York, NY.

Quimette, P.C., Finney, J.W. & Moosand, R.H. (1997). “Twelve-Step and Cognitive-Behavioral Treatment for Substance Abuse: A Comparison of Treatment Effectiveness”. Journal of Consulting and Clinical Psychology (65)2. Pp230-240.

Reichheld, F. F. (2003). The one number you need to grow. Harvard Business Review, 1-11.

Rickert, J. (2012). Patient-Centered Care: What it means and how to get there. Retrieved from http://healthaffairs.org/blog/2012/01/24/patient-centered-care-what-it-means-and-how-to-get-there/ on August 7, 2014.

Simpson, D. D., Joe, G. W., & Rowan-Szal, G. A. (1997). Drug abuse treatment retention and process effects on follow-up outcomes. Drug and Alcohol Dependence, 47 (3), 227-235.

Tonigan, Miller, Chavez, Porter, Worth, Westfall, Carroll, Repa, Martin, & Tracey (2003). “Project Match 10- Year Treatment Outcome: Preliminary Findings Based On the Albuquerque Clinical Research Unit.” Retrieved from http://scottdmiller.com/wp-content/uploads/documents/ MakingTreatmentCountPsychOz.pdf on May 3, 2013.