Again from the Robert Wood Johnson Advancing Recovery conference, David Gustafson did a audio presentation (as he could not attend the meeting in person) focused on the problems of hand-off, discussing how poor our systems are moving an individual from one level of care to another. In statistics presented earlier in the morning Todd Molfenter reported that out of 10,000 individuals referred for substance abuse treatment, only 10 (no I did not drop any zeros) make it through the end of follow-up care. Yes treatment works but the system leaks like a sieve.
David's presentation discussed a wide variety of hand-off lessons learned from football and medicine. He offered clear, usable, and proven techniques for fixing this problem. (Indeed the Advancing Recovery project in Kentucky reported reducing their no show rate of individuals moving from a hospital program to out-patient from 70% to a rate ranging between 30 to 0%.)
One thing stuck a familiar cord. David emphatically stated that hand off failures are never the fault of the human being. They are always the fault of the system . What struck me about this was its similarity to a maxim I developed a number of years ago (Hile's modest maxim and corollary - after all if you are going to name a maxim after yourself you should do so modestly.)
Information will be accurate only if it is useful to the person collecting it.
If people resist collecting information we have not made it useful.
It is clear that unless we carefully develop systems that support their users to move from place to place, to get accomplished what they need to accomplish, our systems will not be successful and that we will loose people who we had hoped to help.