Time to ACT: launching an Addiction Care Team (ACT) in an urban safety-net health system

BMJ Open Quality

article

Marlene Martin¹  Hannah R Snyder²  Diana Coffa²  Scott Steiger¹  Joseph P Clement³  Sumant R Ranji¹  Soraya Azari¹  Oanh K Nguyen¹  Paula J Lum¹ 

[1] Department of Medicine , University of California, San Francisco and San Francisco General Hospital;Department of Family and Community Medicine , University of California, San Francisco and San Francisco General Hospital;Department of Nursing , San Francisco General Hospital

关键词: patient-centred care;    hospital medicine;    healthcare quality improvement;    PDSA;    quality improvement;   

DOI  :  10.1136/bmjoq-2020-001111

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Across the USA, morbidity and mortality from substance use are rising as reflected by increases in acute care hospitalisations for substance use complications and substance-related deaths. Patients with substance use disorders (SUD) have long and costly hospitalisations and higher readmission rates compared to those without SUD. Hospitalisation presents an opportunity to diagnose and treat individuals with SUD and connect them to ongoing care. However, SUD care often remains unaddressed by hospital providers due to lack of a systems approach and addiction medicine knowledge, and is compounded by stigma. We present a blueprint to launching an interprofessional inpatient addiction care team embedded in the hospital medicine division of an urban, safety-net integrated health system. We describe key factors for successful implementation including: (1) demonstrating the scope and impact of SUD in our health system via a needs assessment; (2) aligning improvement areas with health system leadership priorities; (3) involving executive leadership to create goal and initiative alignment; and (4) obtaining seed funding for a pilot programme from our Medicaid health plan partner. We also present challenges and lessons learnt.patient-centred carehospital medicinehealthcare quality improvementPDSAquality improvementhttp://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND