This report describes the efforts of one surgical specialty medical practice to improve customer service and access for its patients. The information presented in this report is based on interviews conducted with staff and management in the specialty practice and in various departments within the hospital and medical center. The first section offers brief background information and a short description of each of the steps in the six-step quality improvement process. The second section offers more detail about the organization and the six steps, and a big-picture look at lessons learned. An appendix lists training courses that were developed for staff and management.

This report describes the successful efforts of one full-service health plan to improve customer service for its members. Customer experience ratings provided by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey indicated that the customer service capabilities of the health plan needed to be improved. The plan adopted a six-step approach to quality improvement based on the well-established Plan-Do-Study-Act (PDSA) cycle: (1) Use CAHPS to flag problems. Confirm CAHPS findings with other plan data. (2) Select performance measures. Develop new ones if needed. (3) Set goals for improvement and write an action plan. (4) Implement the action plan. (5) Assess progress and refine the intervention. (6) Monitor improvements to make sure they hold. The health plan went through the PDSA cycle twice until it developed a mix of intervention strategies that produced results.

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT-2) is a manualized group cognitive behavioral therapy program for co-occurring depression and alcohol and drug use problems. BRIGHT-2 has been designed so that non0́3mental health practitioners, and practitioners with less formal training than professional mental health counselors, can deliver the program, thus providing evidence-based depression treatment to individuals who often do not receive it. BRIGHT-2 is an 18-week program consisting of three modules, each of which focuses on a specific topic0́4thoughts, activities, and people interactions0́4and how it can affect a person0́9s mood and desire to drink or use drugs. The BRIGHT-2 manual consists of a leader0́9s introduction, a session-by-session group leader manual, and a session-by-session group member0́9s workbook; this volume is the group member0́9s workbook.

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) is a manualized group cognitive behavioral therapy program for depression in individuals with co-occurring alcohol and drug use problems. BRIGHT has been designed so that non0́3mental health practitioners, and practitioners with less formal training than professional mental health counselors, can deliver the program, thus providing evidence-based depression treatment to individuals who often do not receive it. BRIGHT is a 16-week program consisting of four modules, each of which focuses on a specific topic0́4thoughts, activities, people interactions, and substance abuse0́4and how it can affect a person0́9s mood. The BRIGHT manual consists of a leader0́9s introduction, a session-by-session group leader manual, and a session-by-session group member0́9s workbook. This volume includes the leader0́9s introduction and leader0́9s manual; the leader0́9s manual includes the same material provided to group members, except that it also includes instructions, highlighted in shaded text boxes, to help the group leader present the program material.

The cover story describes the retirement patterns of the "baby boom" generation and the demographic, economic, cognitive, and health care implications. Other feature stories consider the potential effects of legalizing marijuana in California, the effectiveness of drug enforcement efforts in Europe, and modifications to the No Child Left Behind Act. News items discuss policy choices for the Gulf Coast region, food allergy diagnosis and treatment, the new U.S. health reform law, the benefits of investing in police, and the failure to halt Pakistani-based militants. Other stories commemorate the 40th Anniversary of the Pardee RAND Graduate School and describe RAND's emergence as an international organization.