Audit of Substance Abuse Treatment Facilities in ... - SA HealthInfo

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3.9.1. Monitoring of clients’ progress during the course of treatmentAdministrative and procedural structures and activities that facilitate the monitoring ofclient progress during the course of treatment were explored. These structures andactivities are important as they help facilitate the monitoring of client outcomes posttreatment.Overall, all facilities report developing individualised treatment plans for eachclient and keep documented notes of clients’ progress during treatment (Figure 23). Aslightly smaller percentage of facilities have formal discharge plans for each client(68.8%), collect collateral records from various sources (e.g. case conferences, nursingrecords, assessments for each client) (81.3%) and maintain a formal managementinformation system (e.g. client database) that contains all client records (81.3%).Figure 23.Proportion of substance abuse treatment facilities reporting monitoring ofclients within treatment (%).12010080100 1006981 816040200Individualisedtreatment plansDocumented progressnotesDocumented dischargeplansDocumented collateralcontactsManagementinformation systemOverallBy province, 6 facilities in Free State (85.7%), 1 in Limpopo (50.0%), 2 in Mpumalanga(66.7%), 2 in North West (100.0%) and none in Northern Cape keep documentedindividualised discharge plans. Compared to facilities in other provinces, one facility inLimpopo (50.0%) and none of the facilities in Northern Cape have documented recordsfrom collateral sources. A formal management information system is maintained by 6facilities in Free State (85.7%), 2 facilities in Limpopo (100.0%), 2 facilities inMpumalanga (66.7%), 2 facilities in North West (100.0%) and 1 facility in NorthernCape (50.0%).60
3.9.2. Monitoring of clients’ progress post-treatmentWe also examined the extent to which facilities monitored client progress post-treatment.When facilities were asked about post-discharge monitoring and regular post-dischargefollow-up of all clients, only 62.5% of facilities reported tracking client progress oncethey had completed treatment (Figure 24).However, when asked about specific post-treatment monitoring activities, a relativelylarge proportion of facilities report monitoring clients’ progress telephonically (93.8%)and monitoring clients’ progress during follow-up counselling sessions (93.8%) (Figure24). In addition, 43.8% of facilities report the use of blood tests and/or urinalysis tomonitor clients’ substance use and only 18.8% of facilities use structured follow-upquestionnaires to track clients’ progress post-treatment.Figure 24.Proportion of substance abuse treatment facilities reporting monitoring ofclients post-treatment (%).100908070605040302010063Post-dischargemonitoring andfollow-up9444Telephone follow-up Blood/urine test Follow-up counselling Follow-upquestionnaireOverall9419By province, 4 facilities in Free State (57.1%), 1 in Limpopo (50.0%), 2 in Mpumalanga(66.7%), 2 in North West (100.0%) and 1 in Northern Cape (50.0%) conduct postdischargemonitoring and regular post-discharge follow-up of all clients. All facilitiesreport monitoring clients’ progress telephonically, with the exception of 1 facility inNorthern Cape (50.0%). Similarly, all facilities report monitoring clients’ progress duringfollow-up counselling sessions, with the exception of 1 facility in Limpopo (50.0%). Theonly provinces reporting using blood tests and/or urinalysis to monitor clients’ substanceuse are Free State (42.9%), Limpopo (100.0%) and North West (100.0%). In addition,61
Page 1 and 2:
Alcohol & Drug Abuse Research UnitM
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3.1.2 Treatment facility profile by
Page 5 and 6:
4.3 Targeting barriers to treatment
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EXECUTIVE SUMMARYA cross-sectional
Page 9 and 10: services to historically underserve
Page 11 and 12: use, reductions in criminal activit
Page 13 and 14: Despite high levels of substance ab
Page 15 and 16: Despite the apparent availability o
Page 17 and 18: treatment services provided. At pre
Page 19 and 20: use disorders whose physical and em
Page 21 and 22: delivery, treatment retention, and
Page 23 and 24: audit substance abuse treatment fac
Page 25 and 26: 2.8.3. Further data considerations
Page 27 and 28: Figure 1. Inpatient intensity of ca
Page 29 and 30: Since there is a large overlap betw
Page 31 and 32: the total client population (χ = 4
Page 33 and 34: Figure 7.Comparison of race profile
Page 35 and 36: services per month ranges from 13 t
Page 37 and 38: 3.4.1. Characteristics of staff at
Page 39 and 40: supervision. In contrast, a much sm
Page 41 and 42: In terms of client record-keeping,
Page 43 and 44: Core findings:• Compared to the p
Page 45 and 46: using 12-step approaches, 75.0% rep
Page 47 and 48: Figure 16. Proportion of treatment
Page 49 and 50: 3.7. ADDRESSING BARRIERS TO TREATME
Page 51 and 52: Table 11. Proportion of facilities
Page 55 and 56: Figure 20.Proportion of substance a
Page 59: Table 15. Proportion of facilities
Page 65 and 66: PART 4: DISCUSSION OF KEY FINDINGSW
Page 67 and 68: previous audits of specialist subst
Page 69 and 70: small proportion of South African d
Page 71 and 72: high levels of substance use among
Page 73 and 74: these barriers appears to significa
Page 75 and 76: appropriate services for Black/Afri
Page 77 and 78: clients progress post-treatment, an
Page 79 and 80: • The number of state facilities
Page 81 and 82: • Another way of ensuring (indire
Page 83 and 84: • The age appropriateness of serv
Page 85 and 86: REFERENCESAllard, S.W., Tolman, R.M
Page 87 and 88: Myers, B., & Fakier, N. (2007). Rep
Page 89: Zule, W.A., Lam, W.K., & Wechsberg,
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