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Toolbox: Paths to Effective Communication for an Improvement Initiative Based on the CAB Health and Recovery Services, Inc. Darwin Project, November 1999 to September 2001 Submitted by Margaret Sallade, Project Consultant For more information on the Darwin Project of CAB Health & Recovery Service, Inc. visit: http:www/cabhealth.org or contact Kevin P. Norton, CEO at 978-777-2121. Basic Premises: 1. Three Components of Communication: A. The Message B. The Medium (presentation, press, report format) C. The Means (who delivers message, where, and how) 2. Different Project Stages (Early, Middle, and Late) necessitate different communication objectives. I: Early Stage: Communication for Buy-In Step 1: Assess Communication Options Assessing existing communication systems as well as the “communication culture” within the agency will help determine your communication approach. Before developing a Communication Plan, consider these questions. Who are the primary audiences with whom you need to communicate to achieve a successful improvement project and what message(s) should they receive? The following steps (2-10) outline various audiences important to the Darwin Project and give examples of the message, method, and means to communicate it. What pathways of communication exist within the organization and what resources are there to support communication? For example, what is the organization’s meeting structure and what task forces exist? Is there a communications or public relations specialist? Is there an organizational newsletter? Is there a discussion area on a company homepage? Who has access to e-mail? Is the company electronically linked across sites? Darwin Examples 1. The Darwin project relied heavily on existing meetings as a primary vehicle for communicating the project. The messages were tailored to each meeting and its audience. For example, Darwin team members delivered updates to staff meetings in “staff-to–staff” format using handouts of PowerPoint slides. Team members pointed out that overheads were too cumbersome and too formal for general staff. Handouts were edited to “tone down” process improvement language and simplify the message for staff. In the spirit of the project and “breaking down silos,” team members delivered updates in departments other than their own, creating both interest and exposure on behalf of the staff and team members respectively. One formal, organized presentation was done mid-way through the project lifecycle in which improvement team members traveled to a program other than their own to deliver a project update. Regular, informal updates were discussed at least once per month in staff meetings, or more frequently if needed. (See Step 7.)

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Toolbox: Paths to Effective Communication for an Improvement Initiative Based on the CAB Health and Recovery Services, Inc. Darwin Project,

November 1999 to September 2001 Submitted by Margaret Sallade, Project Consultant

For more information on the Darwin Project of CAB Health & Recovery Service, Inc. visit: http:www/cabhealth.org or contact Kevin P. Norton, CEO at 978-777-2121.

Basic Premises:

1. Three Components of Communication: A. The Message B. The Medium (presentation, press, report format) C. The Means (who delivers message, where, and how)

2. Different Project Stages (Early, Middle, and Late) necessitate different communication objectives.

I: Early Stage: Communication for Buy-In Step 1: Assess Communication Options Assessing existing communication systems as well as the “communication culture” within the agency will help determine your communication approach. Before developing a Communication Plan, consider these questions. • Who are the primary audiences with whom you need to communicate to achieve a successful

improvement project and what message(s) should they receive?

The following steps (2-10) outline various audiences important to the Darwin Project and give examples of the message, method, and means to communicate it.

• What pathways of communication exist within the organization and what resources are there to

support communication? For example, what is the organization’s meeting structure and what task forces exist? Is there a communications or public relations specialist? Is there an organizational newsletter? Is there a discussion area on a company homepage? Who has access to e-mail? Is the company electronically linked across sites? Darwin Examples 1. The Darwin project relied heavily on existing meetings as a primary vehicle for communicating the project. The messages were tailored to each meeting and its audience. For example, Darwin team members delivered updates to staff meetings in “staff-to–staff” format using handouts of PowerPoint slides. Team members pointed out that overheads were too cumbersome and too formal for general staff. Handouts were edited to “tone down” process improvement language and simplify the message for staff. In the spirit of the project and “breaking down silos,” team members delivered updates in departments other than their own, creating both interest and exposure on behalf of the staff and team members respectively. One formal, organized presentation was done mid-way through the project lifecycle in which improvement team members traveled to a program other than their own to deliver a project update. Regular, informal updates were discussed at least once per month in staff meetings, or more frequently if needed. (See Step 7.)

2. Because the Darwin project had six improvement teams, there was an immediate need to establish communication across teams. Prior to the project, only certain managers had e-mail capability. Giving each Darwin team member e-mail access provided a new, immediate method for sending minutes and organizing meetings.

• What is the preferred or most common method of communication within the organization?

For example, are meetings structured or informal? Is there an expectation for documenting and sharing meeting outcomes? Is staff comfortable with oral reports or professional presentations? Is staff reluctant to write reports? Is use of new technology welcomed or feared?

Darwin Examples: 1. Originally, the team leaders were asked to write a monthly update on their teams’ progress and outline goals for the upcoming month. This effort failed. Staff was already overburdened with clinical and administrative paperwork. Oral updates fit the culture and sufficed for updating the CEO and other team members. Oral updates were delivered by team leaders at monthly meetings of the improvement project’s guiding team. They were also delivered monthly at an agency-wide middle management and supervisors’ meeting. 2. At the onset of the project, the Information Technology (IT) consultant developed a mechanism to share meeting minutes on the company’s intranet. This did not work because it was new technology and there were no other functional applications developed. The small group of improvement team members did not have the skills to access this method of information sharing. Although training was provided, staff did not readily use the technology to access information. CAB’s experience is that new technology is most readily accepted if it is directly related to daily job tasks, e.g. client admissions or billing information systems, rather than solely for accessing knowledge of meeting outcomes. 3. Traditionally staff was not skilled in using PowerPoint and delivering professional oral presentations. The first team to present recommendations for approval was coached in using PowerPoint by a consultant and project managers. It was so successful that management recognized and responded to this professional development opportunity by setting expectations that other presentations were to be delivered in this way. (See Step 8.)

• How can information be shared with external audiences?

Darwin Examples: 1. The Director of Development and CEO play critical roles in informing stakeholders and advocating for support by leveraging relationships. 2. Darwin staff were ambassadors of improvement. They were able to talk about their work as they interfaced with peers and peer organizations. 3. CAB had an external newsletter with regular readership. This was an excellent communication vehicle for external audiences. 4. Press releases and news articles were not a primary focus. The general community was not a primary audience interested in internal business process improvements. Press releases were, however, an excellent way to recognize and publicly thank project funders. 5. CAB had two articles published in Behavioral Healthcare Tomorrow to share the project concept and some of its progress with peers in the field of substance abuse treatment (Capoccia, 2000) and

(Levy, 2001). An on-line interview was posted on the web page of the National Leadership Institute which was, at the time, a technical assistance resource for community based organizations funded by the Center for Substance Abuse Treatment. (See Step 7.)

Step 2: Communicating the Project Vision A shared vision is a hallmark for any successful improvement initiative. Once a vision is developed, it should be communicated over and over again and used as a tool to help guide and/or redirect improvement efforts. The CEO’s commitment to the project, and his repeated mentions of it in employee newsletters demonstrated a high level of support for the project. These repeated mentions helped reinforce wide-spread organizational awareness of the project. Initially, guiding team members were concerned about staff understanding the terms “building infrastructure” and “systems development” so every effort was made to illustrate the actual work of improvement teams. Formal and informal feedback from an agency wide survey indicates that staff did understand the project vision. (See Step 11). The widely recognized project name “Darwin” and its association with “survival of the fittest” was easily translated into meaning “a fit organization.” This helped make the vision understandable. What’s in a name? Potentially a lot, if it is chosen carefully. Project names and even logos are, indeed, important. Audience Objective Message Medium/Means Example Team members, staff throughout the organization, key stakeholders, funders--current and potential, peers.

To communicate the vision using language that will create buy-in from multiple audiences.

“Darwin is about building infrastructure to support staff in the work they do to better serve clients.” (Vision statement) “The Darwin name stands for survival of a fit organization.” “Darwin is about improving internal systems.” “Darwin will help us better deliver services to staff and clients.” “Darwin is a unique and critical venture. The organization is committed to improvement.” “Darwin represents the critical business of building and strengthening internal systems that support the organization.”

Selected a project name that reflected the nature and meaning of the project. Referred to Project by name in all written communications for clear identification. CEO launched vision to team members, Board, and employees in meetings and newsletters. Repeated/Reiterated vision and related themes throughout the project. This was initiated by project manager and supported by CEO. E.g. question for guiding team to reflect on “What is this project really about?” E.g. for staff newsletter article, “What does this project mean to me?”

Insights, Nov. 1999 1.Letter from the President (26.tif) 2.“The Darwin Project” (25.tif)

Cabbing Around, Oct. 1999 Kevin’s Kolumn (15.tif)

Developed Darwin “Helix” logo, but was not consistently used on project communication. Provided T-shirts with Project Name to team members.

Step 3: Launching the Project Launching a project is a succinct, formal call to action that requires careful planning. The main objective of this step is to create interest and gain commitment. What CAB discovered in a multi-team improvement project, is that some staff simply had trouble understanding why they were asked to participate. For example, the Food Service Manager wondered why he would be asked to participate in a team designed to improve support services in an organization. The message was clear. The project represented an opportunity for staff to lend their expertise and to participate in shaping changes within the organization. Staff were valued from the start of the project. The project launch also helps set the tone for the improvement initiative. CAB found that setting this project apart from others---having a day-long, off site meeting for example, lent an air of importance to the project. It also provided the appropriate forum for communicating the project vision and expectations. The project launch created the “conversational buzz” in the agency. “What is this Darwin project, anyway?” “Who was invited to participate?” People began to pay attention when they read employee newsletters. Audience Objective Message Medium/Means Example Team members, staff throughout the organization, key stakeholders, funders--current and potential, peers

To create multi-level understanding and buy-in to the project, its vision, and its plan.

“Darwin….is a critical enterprise to help create an infrastructure that will support CAB to continue to grow and meet the needs of the community.” “You are asked to participate because you have the capacity to add value and expertise to the project.”

Staff selected to participate in improvement teams were invited by a special letter from the CEO. Supervisors of Improvement team participants were asked by the CEO to deliver the invitation and support the employees’ time involvement. The organization held a one-day project kick-off meeting that included an explanation of the project, timeline, team expectations, and team-building exercises. Funders were invited attend the kick-off event.

Cabbing Around, Nov., 1999 Kevin’s Kolumn “Project Kick-off” (16.tif) Invitation Letter from the President

II: Middle Stage: The Project & Process—Sharing Information and Maintaining Motivation

General Objectives:

• Communication for Internal Management Support and Accountability • Communication to Inform, Share Knowledge-Internal and External Stakeholders • Communication for Public Relations-“An Innovative Effort” “Investment In Employees”

“Quality Care for Customers” • Communication to Sustain Motivation & “Keep the Wheels Turning” • Communication to Break Team Isolation, “Connect the Dots” across teams and to the larger

improvement initiative • Communication for Coordination

Step 4: Gain Support from the Top

CAB found that keeping the Board of Directors updated was very helpful to the overall support of the project. Individual Board members contributed portions of the matching funds. The project represented innovation, involvement, and initiative on behalf of management of the organization.

Method

Audience Objective Message Medium/Means Examples Board To elicit highest

level of organizational support for project. To leverage Board support in funding of project.

“Darwin is an innovative project—CAB remains on the cutting edge and seeks opportunities to improve and transform its work.” “CAB keeps customers and quality first-Darwin is about better serving staff and clients.” “CAB strives to remain competitive and positioned for change.” “Staff is actively involved in organizational improvements.”

CEO arranged for (2) presentations by Project Manager in Board meetings.

PowerPoint Presentation to Board of Directors Cabbing Around November 2001, “CAB’s Board of Director’s”

Step 5: Leverage Organizational Leadership This step is critical to the success of any improvement project and is often a role of a good change leader. In this case, the project manager who helped coordinate six improvement team efforts was one of the change leaders. The project manager developed a synergistic relationship with the Chief Executive Officer and other senior managers. This is often a pivotal role in developing and maintaining open communication and relationships needed to steer a project to success. Audience Objective Message Medium/Means Examples CEO To keep

management abreast of project needs. To test management willingness to accept proposed solutions.

“Anticipate this, troubleshoot that…” “Do the resources exits to do this?” “Is this what you had in mind as a solution?” “Trust the process. Employees know the business. Trial and error is part of success. “

Project manager meets with CEO to advocate for teams and or project needs.

No written communication examples available.

Sr. Management

To promote shared responsibility and accountability for implementing the improvement process and implementing the solutions.

“Sr. leadership support of the improvement project is expected and is important to its success.”

Project manager helped identify issues for Sr. Management discussion. CEO brought information from project guiding team to Sr. Management meetings as needed for discussion, final approval, and support.

No written communication examples available.

Step 6: Spread the Wealth & Gain Peer Support What CAB learned is that communication with middle management, especially those not directly involved in the project, is equally as necessary as good communication at top levels of the organization. Middle or program level managers are the direct entities for staff support and accountability. At CAB, integrating improvement project updates on existing meeting agendas was a great way to keep middle level managers abreast of the project. It was a way to break down communication silos that often exist between programs. This meeting was managed by the president; therefore, managers were accountable for implementing agenda items. New solutions were owned and announced by improvement teams in a peer forum, but the accountability was enforced by a higher level of management. Staff was positive about regular updates. Providing them also helped create accountability within the teams: they needed to be prepared. Audience Objective Message Medium/Means Middle Management

To convey the on-going value and progress of the improvement project. To help implement changes across the agency and make program managers a point of accountability. To provide change leaders and team members an opportunity for recognition among peers.

“Darwin continues to be an important part of the agency’s work….” “Everyone is expected to help implement changes. Teams have worked hard to propose solutions and they need everyone’s cooperation to implement them.“ “We are working on this and this is the progress we’ve made.”

CEO supports and requests time on middle management meeting agendas for project updates. He recognizes individuals and acknowledges value of work done. Improvement teams reported updates during monthly middle managers and supervisors meeting. Meeting agendas, verbal updates, handouts, meeting minutes.

Cabbing Around September 2000 Kevin’s Kolumn “Recognition of matching funds and IT retreat”

Step 7. Message(s) to the Masses This project has approximately 30 staff people involved out of 200 full time employees across eight locations. To create an agency-wide awareness of the project, several means were used, primarily, the well-read employee newsletters. Improvement teams were asked to write their own updates and submit them to the newsletter on a regular basis. To ensure this, a schedule for writing articles was assigned to each team and put on the agenda of the guiding team—the group entity that helped ensure direction and outcomes of the broader project. The president also regularly gave mention to the project in his monthly column. To reach beyond newsletter readership, the project manager created a PowerPoint presentation to update staff during staff meetings. This presentation was delivered to staff by improvement team members. Feedback from staff was that the language was too “technical” and the improvement efforts should be described in language staff could understand. CAB needed to use language that employees understand to communicate improvements. Project talk such as “process improvement,” “systems change,” and “infrastructure development” is not always understood by staff. Conversely “making work easier” and “better serving clients” are universal improvement themes. After that feedback, another newsletter article was developed that described the benefits of the improvement process from a staff perspective by answering the question “what does this mean for me?” As part of its funding requirement, the Darwin Project was to serve as an example for other community based organizations embarking on improvement processes. To help create awareness of the project among peers in the substance abuse treatment field, CAB published two articles in a behavioral health care journal. (See Step 1). Audience Objective Message Medium/Means Staff /Customers (Note: Darwin customers were largely internal-the end recipients of improved work processes.)

To create an overall awareness of project and its importance to the agency. To demonstrate commitment to quality care for clients. To demonstrate organization’s Commitment to change/improvement. To share information on content and progress of project. To recognize work of peers.

“Darwin is about changing infrastructure to support staff and to better serve clients.” “Improving our work will result in better service to clients.” “CAB will be a better place to work because of this project.” “What does this project mean to me?” “Many staff are working together to make change.”

Cabbing Around-internal newsletter. Project manager and team leaders share role of submitting articles. CEO mentions project in his monthly newsletter column. “Staff to Staff” Darwin project update: presentation to staff at staff meetings by Darwin team members. PowerPoint, handouts Word of Mouth

Cabbing Around, March 2000The Darwin Project, “The Clinical Team Update” Cabbing Around September 2000 “IT Retreat” *Cabbing Around, September 2000 “Multiple Team Updates.” Cabbing Around, January 2001“Darwin Update: A Staff Perspective” PowerPoint Presentation “Darwin Staff Update”

Step 8: Focus on the People Doing the Work This step involves regular, positive feedback and recognition for team efforts. It also involves sharing knowledge across six improvement teams and linking separate improvements to a larger project. This was quite a challenge. Staff has repeatedly commented on the success of the quarterly meetings designed to bring all participants in the project together. The CEO was committed to the project and approved both operational time for staff to attend and funds for tangible rewards. Each of the six improvement teams had a team leader and these leaders formed a guiding team that met monthly to share ideas and garner support for the project. Not all improvement projects need a guiding team or steering committee: the size of the Darwin project warranted one, and team leaders felt this was an effective communication structure. CAB also found that the project provided an opportunity to push forward the use of technology and in so doing, provided professional development opportunities for staff. People who did not previously have e-mail were set up with an account to receive project minutes and messages. After the Darwin project, there were many people other than managers who used e-mail as a regular form of communication across program location. Although this same attempt was tried with developing an intranet and posting minutes on an internal web-page, using web-technology was “too advanced” for most individual’s skill level, even after initial training was provided. (See Step 1.) If this project were implemented today, the result may not be the same because of the advancement in use of technology within the organization. The point for others to consider is to choose a technical application for communication that fits existing patterns of use and/or likelihood of use within the organization. Audience Objective Message Medium/Means Team, Intra-team and Project-Wide

To share content on what teams are doing. To get everyone on the “same page” with project expectations. To clarify objectives and directions. To avoid any duplication. To integrate work across teams if warranted. To brainstorm solutions/problem solve. To identify resources needed. To demonstrate success, recognize work progress,

“There is over 25 staff directly working on this project with many more helping out. Everybody is in this and working together.” “Every team is experiencing challenges and successes. That’s part of the process.” “The approach your team is taking is or is not reasonable because…” or, from CEO, “I was really looking for this…” “This takes time and hard work. That is supported and appreciated by the organization.” “To the extent possible (financially reasonable) the organization will support your solution

Developed e-mail access for each team member (did not previously have) Tried posting minutes on section of CAB’s intranet, but culture was not ready to access information in this way. Guiding Team Meetings. A Guiding Team comprised of improvement team leaders met monthly. Quarterly Project Meetings. Each quarter all members of the 6 improvement teams

Insights, Vol. 1, 2000. “The Darwin Project Survives and Flourishes.”(20.tif) Cabbing Around April 2001 Darwin Project Update: Support Services “transportation project.” Discussion Guide for Quarterly All-team meetings.

collectively and individually. To decrease team isolation and promote a sense of broader team and collective impact. To encourage and support team and individual efforts.

with needed resources.” “(Individual) is doing a great job and we appreciate your time and energy.”

met. Meetings included: an address from the President, updates on progress—team updates or an overview by the Project Manager; facilitated discussion including items such as: “What are your greatest challenges? What resources do you need to support this work? etc. (PowerPoint, small group discussion, etc. were vehicles used.) Provided tangible rewards: luncheons, 2 books on quality improvement—Curing Health Care and Who Moved My Cheese, certificate to book store, etc. Change Leader acts as on-going coach and cheer leader

Step 9: Feed the Funder CAB provided regular project reports to funding sources to keep them abreast of progress. Press releases and news articles were not a primary focus. The general community was not a primary audience interested in internal business process improvements. Press releases were, however, an excellent way to recognize and publicly thank project funders. (See Step 1.) CAB also used existing publications such as the annual report and Insights, a company newsletter distributed to stakeholders, to acknowledge funding status of the project. Creating visibility of on-going funding efforts helps staff believe that an organization is committed to the project and that it must be “worthwhile” if people are investing in it. Audience Objective Message Method/Media Funders & Potential Funders

To relate status of project. To keep project visible and positive. To recognize source of financial support. To solicit further financial support.

“Your investment is being used to…” “Infrastructure development is a value investment in quality improvement for an organization. It helps us support staff and serve clients.” “Thank you.” “Others have thought this is a good investment. We’ve proven it is. Help us continue our work.”

Quarterly written reports developed by Director of Development and Project Manager Meetings as needed Invitations to key project events. Mention funder in Annual Report Mention funders, if not anonymous, in internal and external newsletters.

Cabbing Around August 2000 “Development” Matching Grants Cabbing Around, September 2000 “Development: Darwin Project Fundraising.” Boston Sunday Globe, June 2002“Danvers health service awarded grants.” Marblehead Reporter, June 6, 2002 Business News

III: Late Stage: Project Commencement-Celebrating Success & Sustaining Change Step 10: Giving Thanks, Celebrating Outcomes, and Positioning the Future All projects should incorporate opportunities to reflect on lessons learned and to celebrate success. This can happen at any point throughout a project, but most certainly, it should happen at the end. CAB used both the quarterly all-team meetings and a final closing meeting to do this. A well-facilitated meeting that allows individuals to explore the value and benefit of the project goes a long way in creating a sense of collective accomplishment. Tangible rewards also work if they are meaningful to employees. For example, CAB chose to give participants a stipend for one professional development training. “More training” was a frequent request of employees and making funds available to pursue professional development fit the “improvement theme” of the project. This seemed more appropriate than retail gift certificates, T-shirts, or other less valued rewards. Audience Objective Message Method/Media Team Members External Consultants Funder Potential Funder

To sustain change initiatives. To demonstrate further management commitment to supporting on-going improvements. To demonstrate success and thank staff and funders. To promote future funding of similar efforts.

“The funded “project” is ending, but the effort to improve continues as part of our normal day to day work.” “CAB was successful in creating infrastructure to support change and here is how….” “Thank you for your help. Here is what we did successfully. Here is what we learned.” “This effort is a necessary endeavor for substance abuse treatment organizations. “Thank you for the diligent work performed by staff and the outstanding success they have achieved.” “The agency is poised not only to survive but to thrive while doing what is best quality substance abuse treatment.”

Special Closing Meeting to signify “end” of Darwin Project and formal transition to on-going improvement efforts. Each team reviewed success and challenges, discussed how CAB was different as a result of project, reviewed what was left undone and conducted consensus method of remaining priorities, recognized work, invited consultants and VIPs. Provided tangible rewards: Day off, investment in one paid training of employees’ choice, framed certificate, mug and candy. Draft Guidebook: Formal written

Insights, Vol. 2 2001 “Darwin Retreat: A Milestone in Infrastructure Building.” Crabbing Around, September 2001 “Celebrating Commitment and Change” CAB Annual Report 2001 “The Darwin Project: Looking to the Future” “Development Report: Darwin Infrastructure Project” “Relapse Prevention”

thank you letters to Staff by CEO. Written Summary of Project and lessons learned given to team members, consultants, Board Chair, and Funders Formal thank you letters to external consultants. Press release on subsequent funding for project by RWJ.

Step 11. Evaluate the Communication Plan The evaluation of communication strategies for an improvement project best done in a continuous fashion throughout the duration of the project. Objectives:

A. To evaluate the effectiveness of the communication plan. B. To determine what to do better next time.

To self-evaluate communication during the lifecycle of the project ask the following question:

• What works and doesn’t work regarding the communication plan? • What types of communication do people respond to? • What new communication needs arise?

To evaluate the overall success of the communication plan, consider using an external evaluator to create an employee survey to assess knowledge and perception of the project. Darwin Example CAB Health & Recovery Service, Inc. contracted with JSI Research and Training Institute, Inc. (JSI) to conduct such an end-point evaluation of staff awareness, perceptions and experience with the Darwin project. The survey was distributed to all CAB staff who were employed at the time of the project. A brief summary of some of the results include: .

There was a 75% survey response rate (102 out of a possible 163 respondents.) Of the 102 survey respondents, the majority (62%) had heard of the project. When asked about the general feeling about the Darwin project, the vast majority (80%) felt either

“very” or “somewhat positive” about the project. When asked about the impact of the Darwin project, the majority (78%) felt the project had been

“very effective” to “somewhat effective”. When asked if they felt the Darwin project was innovative, the majority (77%) responded that the

project was “very innovative” to “somewhat innovative.”

In response to a question assessing improved efficiency of the organization, the majority (74%) felt that CAB had become either “much more efficient” or “somewhat more efficient.”

Sixty-five percent (65%) felt the quality of business systems had improved. A majority (69%) felt that the client services had either “somewhat” or “greatly improved” during

the time period in question. These results indicate that the communication of the Darwin project was successful in creating employee knowledge of the project and positive employee perception of its impact on the organization. Summary This work represents one organizations’ attempt at communicating a large-scale improvement project. CAB Health & Recovery Services hopes this serves as a useful tool from which you can explore the message, medium, and means and then tailor a communication approach to fit your organization.

References

Capoccia, Victor A. 2000. “Building Room to Grow.” Behavioral Healthcare Tomorrow 9, no. 3 (June): 20. Levy, Michael. 2001. “Building a System to Prevent Addiction Relapse.” Behavioral Healthcare Tomorrow. (December).

Cabbing Around October, 1999

Insights Vol. 3 1999 “Letter from the President”

Insights Vol. 3 1999 “The Darwin Project”

Cabbing Around November 1999 “Kevin’s Kolumn”

Boston Sunday Globe June 2, 2000 “Danvers health service awarded dual grants.”

Marblehead Reporter June 6, 2002 Business News

Insights, Vol. 2 2001“Darwin Retreat: A Milestone in Infrastructure Building.”

CAB Annual Report 2001“The Darwin Project: Looking to the Future”

CAB Annual Report 2001 “Development Report: Darwin Infrastructure Project”

CAB Annual Report 2001 “Relapse Prevention”

Cabbing Around, March 2000 “The Darwin Project: Clinical Team Update”

Crabbing Around, September 2000 “Multiple Team Updates

Cabbing Around, January 2001 “Darwin Update: A Staff Perspective”

Cabbing Around September 2000 Kevin’s Kolumn

Cabbing Around September 2000 “IT Retreat”

Cabbing Around, January 2001 “Darwin Update: A Staff Perspective”

Cabbing Around, April 2001 “Darwin Project Update: Support Services”

Cabbing Around, September 2000 “Development: Darwin Project Fundraising.”

Cabbing Around August 2000 “Development”

Invitation Letter from the President Dear : Congratulations on your selection to participate in CAB’s Infrastructure Project. The individuals selected represent a cross section of our organization that poses a significant skill set, ability to think critically, and commitment to CAB’s mission. On November 1st, we will convene for the day in a kick off meeting. At that time, you will receive a full orientation to the scope and breadth of this project. This project is one that will help lead CAB into the new millennium and beyond. On November 1st, we will meet at for coffee and bagels at 8:30 a.m. Plenty of food and drink will be present throughout the day. Dress is casual (jeans and comfortable clothing are ok). It is anticipated that you will be free by 4:00 p.m. Please arrange for appropriate coverage so your beeper and phones can be turned off during the day. The enclosed reading materials are to begin the orientation process. Please take the time to read each document to be more fully prepared. It is my hope that as you begin to fully understand this project, you will become as excited and challenged as I am. I look forward to working together. Sincerely, Kevin P. Norton President

Crabbing Around November 2001, “CAB’s Board of Director’s”

Crabbing Around, September 2001 “Celebrating Commitment and Change”

Discussion Guide for Quarterly All-team meetings.

Darwin Update November 1, 2000

Discussion Guide: Please select a group recorder and someone to report out. 1. Elaborate on the main accomplishments your group has made and clarify any questions

regarding your team’s work. 2. What are the current challenges your group faces? 3. How can Darwin involve other staff who have not been participating in teams? 4. What recommendations would you make to help Darwin continue to be successful in

the next 6 months? 5. How do you see the current Darwin initiatives being supported and sustained over the

next 2 years?

Insights Vol. 1 2000 “The Darwin Project Survives & Flourishes”