Page 4 - FOCUS December 2017

COVER STORY
Engagement specialists counsel patients with drug or alcohol addiction in the
hospital during a “reachable moment” and help connect them directly to treatment.
Opiates rewire the brain, and within hours after an addicted person stops using the drug, the brain changes, causing what Dr. Horton calls “primal misery.”
“The best thing we can do is attend to their needs and provide comfort early on.”
He said that the work of the entire care team in developing this clinical pathway and providing the very best care to these patients is the embodiment of Christiana Care’s values — excellence and love.
“What’s been so rewarding about the process is the experience of working in this cross-disciplinary fashion, across service lines and in a unified effort to reduce variation in care for opioid withdrawal,” said Kimberly Williams, MPH, senior research associate at Christiana Care’s Value Institute. Williams and Claudine Jurkovitz, M.D., MPH, senior physician scientist in the Value Institute, designed the study protocol to validate
the screening instrument and are supervising the analysis for the project.
Currently, staff screen about 70 percent of medical admissions. Largely through increased use of the opioid-replacement drug buprenorphine, Christiana Care has reduced 30-day hospital readmissions for opioid withdrawal by 30 percent. The health system also has standardized its discharge processes so that patients can be enrolled into long-term treatment in as little as 12 hours.
“It seems like it’s working. The potential for that is exciting,” said Beverly Wilson, MS, program manager for Christiana Care’s Project Engage, who co-led the implementation and development of the opioid withdrawal pathway. “There are very few that we’ve been aware of who have answered ‘no’ and gone into withdrawal.”
In May 2017, Dr. Horton testified before a U.S. Senate committee about combining medication-assisted | CONTINUED
“When we compare our results to other hospitals’ data, early outcomes of the pathway appear to show a reduction in the rate of patients leaving against medical advice.
“We’ve been able to make an impact.” Terry Horton, M.D., FACP, FASAM 4 • FOCUS DECEMBER 2017