Estimated Time from Planning to Implementation
4-5 months
Operational Considerations
- Team will need to be led by a provider-champion with knowledge of OUD treatment and empowered to prescribe MOUD and medications to control withdrawal symptoms.
- There are a range of existing practice models including consult team composition and strategies for patient identification. Roles to consider:
- A physician or advanced practice provider to manage pharmacotherapy
- Nurse for clinical assessment
- Resource specialist, social workers or other role to help with psychosocial support and
community transition
- Peer or recovery workforce involvement or staffing
- Universal screening versus referral from treatment team
- Often involves working with hospital pharmacy, hospital information technology, and other stakeholders to ensure methadone and buprenorphine are available and accessible.
- Implementation of program could be expedited if aligned internal candidate(s) identified among staff.
- Consider building on an existing framework or workflow for inpatient consult-liaison services.
- Establish a network of partner organizations, including methadone and buprenorphine
clinics, to receive referred patients, and continuously cultivate these relationships.
Evaluation Metrics
- Track the following information to help measure success of the program:
- Number of patients who receive ACS consultation during hospital stay.
- Number of referrals made to outpatient addiction treatment.
- Observed insights from clinical staff regarding efficiency of workflow.
Estimated Cost to Implement
- $120,000-$500,0000
- Varies considerably based on staffing model and existing infrastructure.
- Staff should be able to bill for services.
Available Training and Technical Assistance (TTA)
Footnotes:
1 Englander H, Priest KC, Snyder H, Martin M, Calcaterra S, Gregg J. A Call to Action: Hospitalists' Role in Addressing Substance Use Disorder. Journal of Hospital Medicine. 2020 Mar;15(3):184-187. doi: 10.12788/jhm.3311.
Acknowledgments
We wish to express our thanks to all community partners who have implemented these programs during the HEALing Communities Study. Key insights from these partners were crucial in the development of these resources that will be important tools for programs looking to build on the successes of these strategies to reduce fatal overdoses.