Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Substance Use Disorders Consultation Service (SUDS): Integrating Addiction Services in an Acute Medical Setting Anika Alvanzo, MD, MS The Maryland Addictions Directors Council (MADC) 2014 Mid-Atlantic Behavioral Health Conference November 4, 2014 1 Rationale for SUD Consultation Specialty Services • Hospitalization may be “teachable moment” • Brief interventions demonstrate reduction in alcohol consumption and death rates • Provider factors – under diagnose – under treat – lack confidence in treating McQueen, et al., 2011 Murphy, et al., 2009 Moore, et al., 1989 2 Historical Perspective Intervention Services: 1970’s – ~2000 First Step Day Hospital: 1997 – 2010 SUDS: 2010 – present 3 Mission The Mission of the Johns Hopkins Hospital Substance Use Disorders Consultation Service (SUDS) is to improve the health and quality of life of patients with substance addiction by providing non-judgmental, comprehensive, and patient-centered care and education. The SUDS performs brief behavioral interventions and counseling to patients, facilitates linkage to hospital and community-based alcohol and drug treatment programs, provides guidance on the clinical management of substance withdrawal syndromes, and educates patients, families, healthcare professionals and the community to prevent, identify, and treat persons living with addiction. 4 SUDS Team 5 Who We Are • Medical Director – Anika Alvanzo, MD, MS • Nurse – Patricia Burgee, RN, MSN, MBA • Senior Addictions Therapist – Diane Moses, MSW, M.Ed, LCAD-C • Interventionist – vacant 6 What We Do • Services – Brief Interventions • Motivational Interviewing – Linkage to Treatment Programs – Medical Management of Withdrawal – Pain Management in Patients with Opioid Use Disorders – Buprenorphine Bridging – Patient and Family Education – Healthcare Professional Education 7 Accomplishments • Electronic Documentation – Qualified Service Organization Agreement (QSOA) • Relationship Building – Program Visits • Clinical Database • Improved Clinical Care – Opioid and alcohol withdrawal protocols • Customer Survey – 14-item survey using a 5-pt Likert scale (3.1 – 4.8)8 Challenges • Staffing – Referrals ↑ ~ 30% – 23% not seen (January – March 2014) – Vacation Coverage – No Medical Management Tues/Friday 9 Referral Volume: FY11 – FY14 ↑ 29% from last year 180 160 140 120 100 80 FY 2011 (893) FY 2012 (1430) FY2013 (1457) 60 FY2014 (1876) 40 20 0 10 Challenges • Clinical Database – Difficult to bring current and maintain • Manpower issue – Medical tutorial and undergraduate students • Demonstrating our value – Not a revenue generating service – Must be able to demonstrate cost savings • Readmission, ED visits, LOS, expenditures • Treatment entry & engagement 11 Pearls… • Start building relationships now • Work out policies on information exchange • Standardize procedures and documents • Clinical database – Integration with Electronic Medical Record • Determine outcomes and plan for measurement in advance 12