2. Impact and lessons learned in the implementation of a NBP model across the province of Quebec, Canada

For the past two decades, the Quebec Ministry of Health has committed to health system design based on population needs. To operationalize this decision for substance use services the estimation of needs, determination of service capacity and gap analysis is required - essentially Needs-Based Planning (NBP).

Over a phased approach, a Quebec research team built upon the original Rush alcohol services NBP model for adults, then updated the model to include other drugs based on a sample of 5000 cases accessing specialized addiction services; and finally developed a more comprehendive model, including all levels of the substance use treatment continuum based on a pan-Canadian approach. A Quebec-specific initiative then allowed for the development of an estimation model specific to youth. This progress in the adaptation of the models (adults and youth) convinced the health authorities to promote the implementation of these guidelines across the province with the support of a centralized team.

The implementation of NBP models necessitates a regular support from the research team including presentations and discussion with each regional team and support with local system mapping and interpretation. The regions having more success were those where resources were dedicated to the task. However, even in the regions with less investment in the process, the simple understanding of the model and the service projections, produced important insights for planning.

Implementation of NBP contributed significantly to system planning and priorization. For investment and was viewed positively by authorities. Regular support is necessary for implementation and interpretation.