Our Process

Step 1
First, we help the program do a deep dive into its operation. This provides baseline evaluation data and empowers programs to better understand their own outcomes and processes. We look at performance data, patient outcomes, workflow, standard operating procedures and the clinical model.

To incorporate the client perspective, we also distribute a survey to solicit the consumer experience, expectations and suggestions for improvement.

We combine these data with onsite observation. We sit in on initial assessments, individual and group counseling sessions for each member of the clinical staff and attend treatment team meetings for the first several months of the consultation.

Step 2
We present feedback on the program’s clinical performance, workflow and client survey results. We work collaboratively with the program to define performance measures and patient outcomes and identify the effective change process that fits the program’s needs.

Step 3
The change process swings into action.

IRETA team members go onsite at the program 2-3 days per week, where we provide staff trainings (education) and one-on-one coaching (guidance) to reinforce existing clinical skills and build new ones, where needed. We work closely with staff by attending clinical sessions and debriefing with the counselors after sessions.

At the same time, we build in continuous evaluation of the program’s clinical services. If the clinical model includes peer group sessions, a short client satisfaction survey is taken after each session and entered into a database for the counselor’s use to develop the ethic of a self-reflective practice.

The same process takes place with program management and emphasizes using performance data to drive management and planning decisions.

Step 4
The IRETA team shifts to helping clinical and management staff install processes and the structures to sustain change.

Less time is spent in direct observations of clinical events or management activities. More time is spent guiding the program to make education and self-evaluation a program ethic.


The timeframe of IRETA’s effective change package is two years, although length can vary according to individual needs.

Do You See Change Opportunities?

Have a conversation with IRETA about the challenges you face in your specific setting. Email info@ireta.org to discuss your observations and hear feedback from experienced quality improvement specialists.
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