Transitions of Care

According to the CDC, each day more than 1,000 people are treated in emergency departments for misusing prescription opioids. Especially when patients are taken to the ED after an overdose and an administration of Narcan, there is an opportunity to try to assist patients beyond surviving the overdose. Even though patients may be experiencing withdrawal and cravings for opioids, and thus may not be receptive to assistance, hospitals are implementing a number of strategies to reach patients and provide stronger connections to behavioral health services, including:

• The American Society of Addiction Medicine Criteria. ASAM’s criteria are part of a comprehensive set of guidelines that addiction medicine professionals can use to provide a nomenclature for describing the continuum of addiction services.
• Westmoreland County’s Warm Handoff System. (n.d.) Embedding case managers in emergency departments during peak times for overdose patients to present.
• Recovery Supports for Overdose Survivors. (n.d.) This program connects individuals who have presented at Rhode Island emergency rooms with an opioid overdose with recovery services delivered by certified peer recovery coaches.
• Warm Handoff Protocol Outlines Steps for Helping Overdose Patients. (2016) The Pennsylvania College of Emergency Physicians and the Pennsylvania Departments of Health and Drug and Alcohol Programs partnered to develop this protocol, which was distributed to emergency departments statewide.

Transitions of Care Following Inpatient Treatment Case Examples

• Could peer-recovery coaches help fight drug addiction epidemic? (2016) A new approach involving connecting overdose patients to coaches who have had similar experiences.
• Against the odds, emergency rooms are getting people into addiction treatment. (2017) Crozer-Keystone Health System in Delaware County uses an ED visit to propel someone into addiction treatment instead of the typical “warm handoffs” where a patient is transferred directly from the ED into a treatment program.
• Project Engage seizes “reachable moment” to treat substance use disorder. (2017) The ED team at Christiana Care Health System began screening patients who exhibit signs of substance use disorder – people who are at clear risk of doing further harm to themselves and others and are becoming frequent visitors to the ED. Project Engage has gained attention as an early intervention program for substance use disorders that is improving patients’ outcomes and reducing costs.