The NIATx model was designed to be easily adopted and sustained by organizations and systems without the need for ongoing consultation or complicated processes. It's built to empower teams to identify and make small changes that lead to big improvements. Milwaukee County's behavioral health system first got involved with NIATx in 2011. Since then, NIATx has been implemented, sustained, and disseminated across the county system with the help of the Milwaukee Comprehensive Care Collaborative (MC3) and NIATx Change Project Learning Collaborative.
“Our approach is all about creating positive change through one small change at a time,” says Amy Moebius, who helps coordinate MC3 and the NIATx collaborative as Best Practice Coordinator for the Milwaukee County Community Access to Recovery Services (CARS) program. She also works closely with staff at the county’s contracted agencies that share a commitment to making the behavioral health system better for everyone.
The MC3 goal is ambitious but simple: to build a cooccurring system of care that meets the needs of behavioral health consumers in the best way possible. “And at the heart of this effort are our nine core values, which guide everything we do to improve the quality of care,” adds Amy.
MC3 Change agents are the agency staff who attend monthly Change Agent meetings and lead the way to help create the best system possible for behavioral health consumers by embracing the nine core MC3 values and believing in the importance of continuous quality improvement. The requirement is that all contracted agencies will complete a quality improvement (QI) project annually. Many of these projects are based on making small changes that have a big impact.
“The 2024 MC3 theme is the "The Ripple Effect"—how small changes can create a ripple of positive outcomes that spread across the system,” says Amy.
“The MC3 initiative and our NIATx Learning Collaborative are a perfect example of how this approach can work. Year after year, we’ve continued to support agencies in making improvements, showing that the NIATx model is more than a onetime fix—it’s a long-term strategy that can grow with us.”
The NIATx Collaborative offers monthly collaborative meetings to support contracted agencies in their quality improvement efforts. January: Amy Moebius along with Rick Kastenmeier and Susan Clark, also of Milwaukee County CARS, kick off the collaborative with an introductory session that explains NIATx. The session provides an overview to help prepare participants to follow the process of NIATx tools like the walkthrough and forming their aim statements to select a process that they want to improve.
By summer, the collaborative begins to focus on data collection and analysis. How are agencies collecting information about their progress? Is it working?
October: The NIATx Storyboard Marketplace, held on the last Wednesday of the month. This is where 20 to 40 agencies present their projects.
"We've seen projects covering everything from making waiting rooms more welcoming to solving transportation issues for consumers," says Amy. "It's amazing how one small change, like adjusting appointment times to align with bus schedules, can make a world of difference for consumers who rely on public transit. The power of these projects is that they don't have to be huge to make a huge impact," adds Amy.
One of her favorite examples?
“An agency found that consumers were consistently showing up 15 minutes late for appointments—not because they didn’t care, but because the bus schedule either made them 45 minutes early or 15 minutes late,” says Amy. The agency decided to address this issue through a NIATx change project, which led to a simple solution: adjust the appointment times. “This one small change led to a major improvement in attendance,” says Amy. “This is the kind of success we celebrate—making small changes that have a big impact.”
Every year, more agencies involved in the NIATx Learning Collaborative present their projects at Storyboard Marketplace, held the last Wednesday of October each year. “We started out this just a few agencies presenting,” explains Amy. “In 2023, we had 43 projects, and it was so rewarding to see everyone get excited about making changes.”
View NIATx Storyboard Marketplace presentations from 2023
The 2024 event, held on October 23, showcased an inspiring variety of improvement projects designed to enhance behavioral health services for clients and staff. From simplifying written instructions for those referred to assessment after a DUI to tailoring staff training options to accommodate different learning styles to reimagining a group meeting room to create a more welcoming space, each project reflected a commitment to supporting clients and staff in meaningful ways.
Looking ahead, Amy says MC3 will keep spreading the ripple effect and inspiring more Milwaukee County behavioral health professionals to become change agents. “The MC3 initiative project and our NIATx Learning Collaborative show just how powerful and sustainable the NIATx model is.”
How can you make a small change today that could have a big impact tomorrow?
NIATx Storyboard Marketplace 2024 Highlights Whole Health Clinical Group and Milwaukee Mental Health Associates were among the nearly 30 providers who showcased their change projects at the Storyboard Marketplace.
The opinions expressed herein are the views of the authors and do not reflect the official position of the Department of Health and Human Services (DHHS), SAMHSA, CSAT or the ATTC Network. No official support or endorsement of DHHS, SAMHSA, or CSAT for the opinions of authors presented in this e-publication is intended or should be inferred.