Date of Award

Spring 2019

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

Doctorate of Nursing Practice

Degree Name

Other

First Advisor

Gene Harkless

Second Advisor

Maren Batalden

Abstract

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered with North Suffolk Mental Health to embed two Recovery Coaches in the Emergency Room and Inpatient setting to support and engagement and navigation into treatment for patients presenting to the hospital with addiction.

Aims: The aim of this study is to describe Year One of the Recovery Coach pilot project, with recommendations for improvement to inform further program growth.

Method: The population of patients who worked with a Recovery Coach in Year One is described in terms of demographic information, insurance status and ACO attribution. Semi-structured interviews of patients, Recovery coaches, staff, providers, and administrators were conducted to extract qualitative themes among the stakeholders.

Results: The average patient is described as a 44-year-old, white, low-income, English-speaking male living in a surrounding community with Alcohol use Disorder. Themes emerging from interviews indicate positive support for the program from all stakeholder perspectives. Strong themes of value in patient engagement, Recovery Coach empowerment, and influence on staff and provider work satisfaction emerge, as well as several areas of opportunity for program improvement.

Conclusions: The findings of this study provide valuable stakeholder input that will improve the program and inform its expansion. The findings should not be generalized to other programs, as the CHA inpatient-based Recovery Coach model is different than other programs described in the literature. However, this study may be of interest to another hospital planning to develop an inpatient-based model.

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