A strategy for inpatient integration.

Hospitals have emerging imperative with a need to improve on safety, health care costs, and Joint Commission compliance. Inpatient services in hospitals see much higher rates of alcohol use disorder and substance abuse compared to general society, as well as significant medical comorbidities and expensive revolving doors (higher use of emergency care, increased readmissions, etc.). For that reason, hospitals need pragmatic methods to screen, diagnose, and treat substance abuse.

This presentation describes the primary hospital system in Delaware, one of the Nodes of the National Drug Abuse Treatment Clinical Trials Network. Before 2009, the Christiana Care Health System had no standardized alcohol/substance abuse screening or withdrawal treatment. In October 2009, they launched a screening and treatment/monitoring program that resulted in improved safety, more engagement with treatment, and shorter inpatient stays. The CTN offers many opportunities for inpatient-based research, such as defining and developing tools for screening and safety improvement, testing methods for treatment engagement and ongoing care, and studying clinical and fiscal outcomes.