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A Clinical Guide to Support the Implementation of Addiction Consult Services and the Value of Teaching and Technical
Sarah Fielman1, Jennifer McNeely, Amy Fitzpatrick
1From the Department of Community Health Sciences, School of Public Health, Boston University School of Public Health, Boston, MA (SF); Department of Population Health, Section on Alcohol, Tobacco and Drug Use, NYU Grossman School of Medicine, New York, NY (JM, CK, NA); Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA (AF, ZMW); Boston University School of Medicine, Boston Medical Center, Boston, MA (TK); Grayken Center for Addiction, Boston Medical Center, Boston, MA (MT); Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine, Boston Medical Center, Boston, MA (AYW); and Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, Boston, MA (SK).
Abstract:
People with substance use disorders (SUDs) are increasingly admitted to general hospitals; however, many hospital systems lack both formal structures and skilled staff to provide high-quality care for inpatients with SUDs. Inpatient addiction consult services (ACSs), which are increasingly being implemented around the country, are an evidence-based strategy to add focused care for people with SUDs into the general medical setting. In 2018, New York City Health + Hospitals (H + H) launched an ACS program called Consult for Addiction Care and Treatment in Hospitals in six hospitals, supported by a team of addiction consult experts to deliver teaching and technical assistance (TTA) for the Consult for Addiction Care and Treatment in Hospitals ACSs. This commentary describes the TTA, which included site visits, introductory educational lectures, case conferences, ad hoc support, implementation assistance, and the creation of an addiction care guide. Similar TTA services could be used in the future when hospitals or systems want to launch novel clinical programs.
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