Sustaining Organizational Change with NIATx Tools

The NIATx model is widely recognized for driving rapid-cycle improvements using the essential NIATx tools and steps for change. However, staff turnover, shifting priorities, and limited resources can all contribute to backsliding into old habits. How can organizations make sure that improvements become standard operating procedure?

In this post, we’ll explore how embedding the NIATx tools into standard procedure can help organizations sustain improvements.

Leveraging NIATx Tools for Long-Term Success

Walk-throughs as a continuous practice. The first time an organization conducts a NIATx walk-through, it’s often an eye-opening experience that reveals unexpected barriers and inefficacies hiding in plain sight. A walk-through shifts perspectives on what clients truly experience when seeking care. Making the walk-through a routine practice can help uncover more barriers and yield ongoing improvements.

Example: A mental health clinic used a walk-through to examine a client’s first contact with the agency and identified excessive paperwork as a barrier during intake. After streamlining forms and reducing redundant questions, no-shows dropped significantly. Six months later, another walk-through focused on the agency’s website. This revealed that website visitors had to make multiple clicks to access information on how to schedule an appointment. To fix this, the team redesigned the homepage with a clear "Get Started" button linking to a simple online form. Appointment scheduling improved and calls from confused clients decreased.

Data-Driven Decision Making. When launching a change project, organizations collect baseline data on key metrics such as appointment show rates, wait times, or continuation rates before making changes using the PDSA Cycle. While teams are motivated and inspired by seeing data confirm whether or not an improvement is working, enthusiasm for data collection often fades once the first change project ends.

Example: A substance use disorder treatment agency had never systematically tracked client no-shows. Staff knew that missed appointments were a problem, but without data, they couldn’t measure the extent of the issue or identify patterns. As part of their first NIATx change project, the team began tracking now-show rates and discovered that nearly 30% of clients missed their first appointment.

Motivated by the data, the team tested a simple change: sending automated text reminders 24 hours before scheduled appointments. Within weeks, they saw a 25% drop in no-shows, and even better–more clients arrived on time. Seeing real numbers gave the team a renewed sense of excitement about data collection and its potential to drive meaningful change.

Six months later, the team conducted another data review and found that while first-appointment no-shows had decreased, follow-up appointment no-shows remained high. This insight led to a second test: adding a follow-up text three days after the initial appointment to check in with clients and offer easy rescheduling options. This step further reduced follow-up no-shows by 15%. After the second test, the agency made a commitment to using data not just as a one-time fix but as an ongoing tool for improvement.

Building a Culture of Continuous Quality Improvement

These are just two examples of how organizations can use NIATx tools to sustain change. The NIATx model is more than just a tool for quick fixes. It provides a long-term framework for building a culture of continuous quality improvement. By embedding walk-throughs, data-driven decision-making, and other NIATx tools into routine operations, organizations can make sure that process improvements are sustained and evolve to meet new challenges.

To learn more, visit niatx.wisc.edu

Join the next virtual NIATx Change Leader Academy:

Four sessions, June 2, 9, 16, and 23, 1–2:30pm CST

Coming soon: NIATx Change Leader Academy E-learning Course!