The opioid epidemic has been named a national crisis for several years. The data for the city of Chicago, shows that in the neighborhoods surrounding Rush University Medical Center, the rates of opioid use disorder and opioid related deaths surpass city and national averages. In efforts of addressing the epidemic, on October 23, 2017, the Substance Use Intervention Team (SUIT) was launched in the Rush University Medical Center to provide a comprehensive program for substance use screening and treatment on the inpatient medical and surgical units as well as in an Addiction Medicine Clinic on Rush’s Campus.
This endeavor involve intensive and targeted utilization of the electronic medical record and interdisciplinary participation from inpatient nursing, hospital case management, pharmacy, and our own interdisciplinary Substance use intervention team and clinical staff. The admission navigator as well as flowsheets within the electronic medical record (EMR) were leveraged to seamlessly integrate non-bias screening questions to be asked of all individuals receiving inpatient care. This interdisciplinary endeavor is purposed to promote universal screening for all substance use, decease stigma and biases regarding substance use in the health care setting as well as support early intervention and efficient comprehensive care.
In addition to universal screening, Rush recognized the barriers to treatment that many patients and hospital staff encounter, such as access to care, affordability of comprehensive care, and education around addiction and addiction treatment. Rush addressed these barriers by opening an Addiction Medicine Clinic which is staffed by the same members of the inpatient consult team along with a full time licensed clinical social worker and medical assistant. The barrier of affordability is often a result of patients having inadequate coverage of mental health and addiction treatment from their insurance or having no insurance at all. The Addiction Medicine clinic helps to alleviate these barriers by being situated outside of psychiatry and providing free case management services. This program also created an education platform for patients and staff alike, allowing for staff training for motivational interview for inpatient social work, online modules for inpatient nursing, and patient education regarding medication assisted treatment and naloxone in the outpatient clinic.
As a result of this SUIT Intervention, Rush was able to improve the standard or care for substance use disorders across the medical center, identify a unique population in need of intervention and provide them with comprehensive care, increase communication between different types of clinicians and levels of care, provide access to the appropriate clinical care, and decrease the length of stay and readmission rates for individuals in this population.
We are excited to have been awarded an second year of funding from the Illinois Department of Human and Health Services to continue this initiative and are continuing to expand our reach by creating education programs to equip providers across the state with tools to continue to relentlessly fight this epidemic.
Niranjan Karnik, MD, PhD, is the Cynthia Oudejans Harris, M.D., Professor and Vice Chair for Innovation in the Department of Psychiatry at Rush Medical College and a conjoint faculty member in the Department of Community, Systems and Mental Health Nursing at the Rush College of Nursing
Kristin Hill, MA is the Practice Administrator for the Section of Population Behavioral Health in the Department of Psychiatry at Rush University Medical Center