Opioid and substance use disorder remains a crisis, intensifying as repercussions of COVID-19 continue to take their toll. Mobilizing community-based resources and creating awareness to the disease are essential to population health and timely treatment. In 2018, Catholic Health (Long Island) adopted a collaborative approach to help emergency department patients presenting with SUDs get the appropriate care.
Catholic Health’s goal was not solely to treat the acute medical needs of patients presenting to the ED, but to facilitate the “warm handoff” and connect them with a community-based peer navigator program in partnership with Family and Children’s Association to follow them through the recovery process. This unique approach has three parts:
A Plan-Do-Study-Act approach was used to implement the program and included clinicians from the health system, religious agencies and multiple community agencies with experienced leaders in addiction recovery. Data revealed the need for alcohol-related abuse and dependency was greater than expected. While the program was originally intended for opioids only, it was expanded to other substances based on this need. The partnership with Family and Children’s supplied peer navigators or “Sherpas”: one designated to guide the patient through the treatment process and the second to support the family members or caregivers impacted by the disease.
The one-hospital pilot decreased ED utilization of this population after the intervention by 44.6% out 180 days, and 58.4% out 90 days. At the pilot hospital, 96% of the ED physicians have been trained in Suboxone administration. Since 2018, a total of 969 patients have been referred to the Sherpa program.
This program has been a great addition to the commitment at Catholic Health to combat the substance abuse crisis. System-wide opioid prescribing guidelines, Narcan distribution programs and Naloxone guidelines have also all been implemented. A data-driven approach has helped engage all stakeholders. The Sherpa program provides another tool for Emergency Medicine clinicians to deliver the care their patients need.
For more information, contact Christopher C. Raio, MD, MBA, FACEP, medical director, emergency medicine, at (631) 376-3000 or firstname.lastname@example.org.