-
https://d1y502jg6fpugt.cloudfront.net/13418/archive/files/49919d5bf8432dc40c1432876db5ad7c.pdf?Expires=1712793600&Signature=YLkObzegdT5lKu9m0VDJ6ePeu%7E3s4wKKYDQu1XDa5-hsP1AyIKzRD6M0fjL52i-eBXuBx2%7EZeve7gi5cI8XH9CN1HfJENManPEHX4hRS%7EkA0leqYhO10OiEDbjOej1UiWhrxrWkeW80z5hsIx%7Etlil7oHBgbZ3JVqOYsikrdCQS1awqwD0P6JkT95dfdyASRNgpsb6sVoVMBAs1CbEcuhSrJZlNPLgEstoR3tR3X4sOwrpeanx1k8ef-JlKBW7XrsWy3TBB7twqTxgakxqBRrecE209ebwOlEuhDn35YX4PpgMB6Wl977vmaXvyyXn3v%7EBKdU77tn-0tu94mq2vxOg__&Key-Pair-Id=K6UGZS9ZTDSZM
05ba8da5e3db01d0c35d6e755fdd54fa
PDF Text
Text
Using available resources to treat Opioid Use Disorder
Kevin Hill, MD; Leslie Bosworth, LICSW; Joanne Devine, PMHCNS-BC CARN
Beth Israel Deaconess Medical Center
The Problem
Integrating treatment for opioid use disorder (OUD) during an acute hospitalization is an important
element of care for patients with this disease.
Based on data from a 2015 study by BIDMC’s Infectious Disease, we know that patients with OUD are
likely to relapse, to have readmissions, and to have high mortality rates.
The same study of BIDMC patients looked at 102 patients with injection drug use and endocarditis
between 2005-2015 and found:
- Only about half the discharge summaries mentioned substance use disorders
- Only 7.8% of patient had a plan for medication assisted treatment
As the opioid crisis impacts BIDMC’s patient population, we have developed new ways of intervening,
treating, and planning care. The study below aims to outline BIDMC’s resources for addressing OUD and
examining how often we offer those resources to patients.
Aims
First, our aim is to develop various interventions that BIDMC’s providers can offer to patients who have
opioid use disorder. Such interventions are detailed in the graph (right), and include naloxone/Narcan
scripts and addiction medications.
Second, our aim is to help providers understand what they can offer and feel comfortable doing so.
- Through chart review, we collected data about which interventions have been used for any patient with
opioid use disorder admitted between May-September 2017 and who came to the attention of the
Addiction Psychiatry Team.
- This incudes 48 distinct patients.
The Team
Any member of patients’ care team on any medical or surgical service, including the attending, resident,
intern, NP or PA, nurse, or unit social worker, helped implement these interventions. The Addiction
Psychiatry Team, supported by the Opioid Care Committee, began collecting data about OUD patients
before formally starting as a team in September 2017.
Progress to Date
% an intervention was used when indicated
Narcan prescribed
OUD addressed in discharge
summary
Linkage with community treatment
Pain consult
Harm reduction education
Team huddle
Communication with outside
providers
Peer recovery volunteer
Addiction medication treatment
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
Lessons Learned
Based on past data from patients with injection drug use and endocarditis, BIDMC has made
tremendous gains. Areas of of particularly high growth are starting patients on medication assisted
treatment, a very important element of addiction recovery.
We still have room for improvement, especially in prescribing patients with naloxone/Narcan, linking
patients to community treatment and teaching patients how to reduce risks of drug use.
Next Steps
Ongoing provider education at every level of clinical practice.
Continue expanding the variety of resources available to providers to most effectively and efficiently
address addictions.
Continue making inpatient addiction interventions easily and quickly accessible for patients and
providers.
For more information, contact:
Leslie Bosworth, LICSW, clinical social work, Lboswort@bidmc.harvard.edu
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Silverman Symposium
Description
An account of the resource
Each year the Silverman Symposium poster session offers BIDMC staff and affiliates the opportunity to share experiences and learn about efforts to improve Quality and Safety.
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Silverman Poster
Primary Contact
If you would like more information about this project, contact this person. Make email address clickable.
Leslie Bosworth (<a href="mailto:lboswort@bidmc.harvard.edu">lboswort@bidmc.harvard.edu</a>)
Department
Any departments listed on the poster or identified in the spreadsheet.
Division of Addiction Psychiatry
Social Work
Opioid Care Committee
Nursing
Project Team
Kevin Hill
Leslie Bosworth
Joanne Devine
BIDMC Location
The BIDMC location where the poster team resides if identified in spreadsheet. If not identified, choose BIDMC.
BIDMC
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Using Available Resources to Treat Opioid Use Disorder
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
Format
The file format, physical medium, or dimensions of the resource
pdf
Effectiveness
Efficiency
Safety