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Time to ACT: launching an Addiction Care Team (ACT) in an urban safety-net health system.
BMJ Open Qual. 2021 01; 10(1)BO

Abstract

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.

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Authors+Show Affiliations

Department of Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, California, USA marlene.martin@ucsf.edu.

Department of Family and Community Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, CA, USA.

Department of Family and Community Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, CA, USA.

Department of Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, California, USA.

Department of Nursing, San Francisco General Hospital, San Francisco, California, USA.

Department of Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, California, USA.

Department of Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, California, USA.

Department of Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, California, USA.

Department of Medicine, University of California, San Francisco and San Francisco General Hospital, San Francisco, California, USA.

MeSH

HospitalizationHospitalsHumansInpatientsPatient Care TeamSubstance-Related DisordersUnited States

Pub Type(s)

Journal Article

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33500326

Citation

Martin, Marlene, et al. "Time to ACT: Launching an Addiction Care Team (ACT) in an Urban Safety-net Health System." BMJ Open Quality, vol. 10, no. 1, 2021.

Martin M, Snyder HR, Coffa D, et al. Time to ACT: launching an Addiction Care Team (ACT) in an urban safety-net health system. BMJ Open Qual. 2021;10(1).

Martin, M., Snyder, H. R., Coffa, D., Steiger, S., Clement, J. P., Ranji, S. R., Azari, S., Nguyen, O. K., & Lum, P. J. (2021). Time to ACT: launching an Addiction Care Team (ACT) in an urban safety-net health system. BMJ Open Quality, 10(1). https://doi.org/10.1136/bmjoq-2020-001111

Martin M, et al. Time to ACT: Launching an Addiction Care Team (ACT) in an Urban Safety-net Health System. BMJ Open Qual. 2021;10(1) PubMed PMID: 33500326.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Time to ACT: launching an Addiction Care Team (ACT) in an urban safety-net health system. AU - Martin,Marlene, AU - Snyder,Hannah R, AU - Coffa,Diana, AU - Steiger,Scott, AU - Clement,Joseph P, AU - Ranji,Sumant R, AU - Azari,Soraya, AU - Nguyen,Oanh K, AU - Lum,Paula J, PY - 2020/07/08/received PY - 2021/01/02/revised PY - 2021/01/10/accepted PY - 2021/1/27/entrez PY - 2021/1/28/pubmed PY - 2021/9/30/medline KW - PDSA KW - healthcare quality improvement KW - hospital medicine KW - patient-centred care KW - quality improvement JF - BMJ open quality JO - BMJ Open Qual VL - 10 IS - 1 N2 - 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. SN - 2399-6641 UR - https://www.unboundmedicine.com/medline/citation/33500326/Time_to_ACT:_launching_an_Addiction_Care_Team__ACT__in_an_urban_safety_net_health_system_ DB - PRIME DP - Unbound Medicine ER -