Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

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 National Treatment Center Study (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. © Health Research and Educational Trust.