Emergency Department Recovery Coach

Objective

Provide additional value-added resources for Emergency Department patients wanting assistance with their substance use disorder.

Overview

A Recovery Coach is a trained personal guide or mentor for people who are either seeking or are engaged in the process of recovery from alcohol and other drug addictions. Recovery coaches do not provide clinical services; they provide the critical support or link to the services and supports that a person needs to achieve and sustain recovery.

Having immediate support when crisis occurs is a high priority for effective engagement with treatment, hence the focus of this project in bringing access to Recovery Coaches to Dartmouth-Hitchcock’s Emergency Department. When a patient presents for emergency care related to harmful use of substances and s/he expresses a desire for treatment or motivation for recovery, then services of a Recovery Coach will be activated as part of the treatment plan.

As with all of the SUMHI projects, this one also seeks to optimize an interdisciplinary approach to the complex array of mental health, physical health, and addiction supports and services.

Patients/populations impacted

• Emergency room patients in crisis and expressing need for help with substance use

Process/systems being improved

• Integration of Emergency Services and Recovery supports
• Screening tools and practices
• Evidence-based addiction treatment
• Alignment with community resources on shared goals

Provider teams involved

• Emergency Department
• Community Recovery Coaches

Economics of care

• Emergency Department visit reduction and Emergency Department operations efficiency

Project team

Leaders

• Patricia L. Lanter, MD, MS is an Emergency Department physician.
• Janet Carroll, RN, CEN, SANE-A is an Emergency Department nurse.
• Greg Norman, Director, Community Health Improvement
• Barbara Farnsworth, Manager, Community Health Improvement
• Bridget Aliaga, Community Health Partnership Coordinator, Community Health Improvement
• Ashley Greenfield, Community Health Partnership Coordinator, Community Health Improvement

Members

• DHMC Recovery Coaches

Learning and data

Program data tracking:

• Number of times recovery coaches activated to the ED
• 30- and 90-day follow-up
• Emergency Department team feedback
• Number of patients assisted to assessment or long-term recovery coaching

Summary of the Recovery Coach program pilot process in the Dartmouth-Hitchcock Medical Center Emergey Department

Persons with substance use disorders often engage with Emergency Department services because of injury or disease resulting from their substance use disorder, or because they are in a substance use disorder-fueled crisis and are seeking treatment services. In the past, the D-H ED could only provide these patients with information and phone numbers for follow-up treatment services. Now, with the availability of on-call ED Recovery Coach services, a relationship can be initiated between a patient and a D-H team member, whose role is to follow-up post-ED discharge to help patients successfully engage in appropriate behavioral health care and/or peer recovery-based follow-up services.

Resources

• States See Peer-Recovery Coaches As A Way To Break The Addiction Epidemic
  Use of peer recovery coaches in Rhode Island Emergency Departments (Kaiser Health News)