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Multidisciplinary Perspectives on a New Hospital Addiction Consult Service: A Mixed- Methods Study.

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Hospital Addiction Consult Services (ACS) improve substance use disorder (SUD) care, but nurses report lower perceived benefits. Enhancing ACS integration and training for all clinicians can optimize care delivery and support.

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Area of Science:

  • Addiction Medicine
  • Healthcare Systems
  • Nursing Practice

Background:

  • Hospital-based Addiction Consult Services (ACS) are increasingly vital for managing substance use disorders (SUD).
  • Understanding diverse clinician perceptions of ACS impact is crucial for optimizing their effectiveness.
  • Varying roles may influence how physicians, Advanced Practice Providers (APP), and nurses perceive ACS contributions.

Purpose of the Study:

  • To assess and compare attitudes and perceptions of hospital-based ACS among physicians, APPs, and nurses.
  • To identify potential disparities in perceived impact of ACS across different clinical roles.
  • To explore strategies for enhancing ACS integration and effectiveness in inpatient settings.

Main Methods:

  • A web-based survey was administered to physicians, APPs, and nurses 18 months post-ACS implementation.
  • Semi-structured interviews were conducted 7-9 months post-implementation to gather qualitative insights.
  • Survey data were analyzed using descriptive statistics and chi-squared tests; interviews used thematic content analysis.

Main Results:

  • Most clinicians perceived positive impacts of ACS on patient care; 311 of 793 clinicians responded (39% response rate).
  • Nurses reported significantly lower perceived improvements in care quality and communication compared to physicians and APPs (p < 0.001).
  • Qualitative data revealed nursing concerns regarding communication gaps, limited integration, and need for SUD training.

Conclusions:

  • Inpatient ACS positively influence SUD care but can be enhanced through better integration of all frontline providers.
  • Embedding nurses within ACS, fostering multidisciplinary collaboration, and providing standardized SUD training are recommended.
  • These strategies can improve team cohesion and ensure all providers feel equipped to manage patients with SUD.