NCAD Spotlight: Counselors` Presence in Hospital Enhances Referral Prospects

Gateway Foundation's presence in nine hospitals in and around Chicago certainly has generated a business benefit for the addiction treatment organization, but that is not the factor that most pleases Gateway's executive director.

“What's really rewarding for me as an administrator is fostering a partnership among my agency, the state and other providers,” Sally Thoren, CADC, tells Addiction Professional. “We place people across the entire delivery system.”

At this month's National Conference on Addiction Disorders (NCAD) East in Baltimore, Thoren will co-present a breakout session on lessons learned as the organization enters the third year of Project Warm Handoff. Gateway clinicians meet with hospital patients whose presenting issues are related in some way to an opioid use disorder and connect them to post-hospital care at a level they are willing to accept at that “treatable moment.”

“We have cared for and referred more than 1,500 patients,” says Thoren. “In the ER, there is not a lot of time for the staff to engage someone—they have to triage and move on. We can ask the sensitive questions.”

And the work is not about Gateway's clinical expertise alone. The organization also has been able to assist in uncomplicating the process of identifying how a patient's ongoing care might be funded. The initiative itself is supported by federal opioid response grants funneled through the state, and operates as a component of Illinois' Opioid Action Plan.

Patient population

The patients who are seen as part of Project Warm Handoff end up in the hospital because of a variety of issues, not in all cases because of an overdose. A number of crises that are complicated by opioid use may be in play.

Thoren says every patient who is seen by the Gateway counselors (mostly master's-prepared) who are located at the hospital leaves with resources and information. “It's really about the conversation,” she says. “We're not diagnosing.”

The team uses a Screening, Brief Intervention and Referral to Treatment (SBIRT) approach. If the patient is amenable to a placement after leaving the hospital, an attempt is made to schedule an appointment at a level of care the patient is willing to accept. “There can be a handoff right away,” Thoren says. “That's not the majority of times, but a lot of times.”

If the patient expresses ambivalence and nothing formal is scheduled at the time of hospital discharge, a peer support specialist will connect with the individual in an attempt to keep the patient engaged in the idea of ongoing care.

Thoren, who will co-present the Aug. 15 session with Gateway's Lake County executive director, Karen Wolownik-Albert, LCSW, says the workshop will emphasize the project's inroads in reducing the stigma associated with seeking help for an opioid use disorder. In addition, she says the session will stress the importance of collaboration between funders and providers, reducing the tension between the business and empathetic aspects of care.

Join clinicians and executives at NCAD East, Aug. 15-18 in Baltimore, and work to improve and refine patient care as well as develop sustainable and successful treatment organizations.