TY - JOUR
T1 - Spreading Addictions Care Across Oregon’s Rural and Community Hospitals
T2 - Mixed-Methods Evaluation of an Interprofessional Telementoring ECHO Program
AU - Englander, Honora
AU - Patten, Alisa
AU - Lockard, Rachel
AU - Muller, Matthew
AU - Gregg, Jessica
N1 - Funding Information:
ECHO was funded through the Oregon State Targeted Response Grant and was free for all participants.
Funding Information:
The authors would like to acknowledge the ECHO participants; ECHO faculty, lecturers, and fellows including Jackie Sharpe, Stacey Mahoney, Susannah Lujan-Bear, Sean Mahoney, Brittney Caldera, Traci Lundy, Lisa Whitmore, Juliana Wallace, Emily Skogrand, Dr. Ximena Levander, Dr. Jennifer Hartley, Dr. Raymundo Garcia-Dwyer, Dr. Casey Ferguson, Dr. Jonathan Robbins, Dr. Alyson Smith, and Dr. Cydney Heims; and Marie-Annick Yagapen and Dr. Gabriel Plourde for their support. They would also like to thank Maggie McClain McDonnell, Terry Wilson, Miriam Wolf, and the entire Oregon ECHO Network; Katie Harris and Danielle Meyers from the Oregon Association for Hospitals and Health Systems (OAHHS); Caroline King MPH for her help with statistical analysis and review; Dr. Jennifer McNeely for help developing surveys; Dr. Christina Nicolaidisfor her help with evaluation; and, Pamela Pierce for her assistance building a resource repository. Finally, the authors would like to thank Dr. P. Todd Korthuis for his support in obtaining?funding for this ECHO.
Publisher Copyright:
© 2020, Society of General Internal Medicine.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Background: Despite evidence of effectiveness, most US hospitals do not deliver hospital-based addictions care. ECHO (Extension for Community Healthcare Outcomes) is a telementoring model for providers across diverse geographic areas. We developed and implemented a substance use disorder (SUD) in hospital care ECHO to support statewide dissemination of best practices in hospital-based addictions care. Objectives: Assess the feasibility, acceptability, and effects of ECHO and explore lessons learned and implications for the spread of hospital-based addictions care. Design: Mixed-methods study with a pre-/post-intervention design. Participants: Interprofessional hospital providers and administrators across Oregon. Intervention: A 10–12-week ECHO that included participant case presentations and brief didactics delivered by an interprofessional faculty, including peers with lived experience in recovery. Approach: To assess feasibility and acceptability, we collected enrollment, attendance, and participant feedback data. To evaluate ECHO effects, we used pre-/post-ECHO assessments and performed a thematic analysis of open-ended survey responses and participant focus groups. Key Results: We recruited 143 registrants to three cohorts between January and September 2019, drawing from 32 of Oregon’s 62 hospitals and one southwest Washington hospital. Ninety-six (67.1%) attended at least half of ECHO sessions. Participants were highly satisfied with ECHO. After ECHO, participants were more prepared to treat SUD; however, prescribing did not change. Participants identified substantial gains in knowledge and skills, particularly regarding the use of medications for opioid use disorder; patient-centered communication with people who use drugs; and understanding harm reduction as a valid treatment approach. ECHO built a community of practice and reduced provider isolation. Participants recognized the need for supportive hospital leadership, policies, and SUD resources to fully implement and adopt hospital-based SUD care. Conclusions: A statewide, interprofessional SUD hospital care ECHO was feasible and acceptable. Findings may be useful to health systems, states, and regions looking to expand hospital-based addictions care.
AB - Background: Despite evidence of effectiveness, most US hospitals do not deliver hospital-based addictions care. ECHO (Extension for Community Healthcare Outcomes) is a telementoring model for providers across diverse geographic areas. We developed and implemented a substance use disorder (SUD) in hospital care ECHO to support statewide dissemination of best practices in hospital-based addictions care. Objectives: Assess the feasibility, acceptability, and effects of ECHO and explore lessons learned and implications for the spread of hospital-based addictions care. Design: Mixed-methods study with a pre-/post-intervention design. Participants: Interprofessional hospital providers and administrators across Oregon. Intervention: A 10–12-week ECHO that included participant case presentations and brief didactics delivered by an interprofessional faculty, including peers with lived experience in recovery. Approach: To assess feasibility and acceptability, we collected enrollment, attendance, and participant feedback data. To evaluate ECHO effects, we used pre-/post-ECHO assessments and performed a thematic analysis of open-ended survey responses and participant focus groups. Key Results: We recruited 143 registrants to three cohorts between January and September 2019, drawing from 32 of Oregon’s 62 hospitals and one southwest Washington hospital. Ninety-six (67.1%) attended at least half of ECHO sessions. Participants were highly satisfied with ECHO. After ECHO, participants were more prepared to treat SUD; however, prescribing did not change. Participants identified substantial gains in knowledge and skills, particularly regarding the use of medications for opioid use disorder; patient-centered communication with people who use drugs; and understanding harm reduction as a valid treatment approach. ECHO built a community of practice and reduced provider isolation. Participants recognized the need for supportive hospital leadership, policies, and SUD resources to fully implement and adopt hospital-based SUD care. Conclusions: A statewide, interprofessional SUD hospital care ECHO was feasible and acceptable. Findings may be useful to health systems, states, and regions looking to expand hospital-based addictions care.
KW - ECHO model
KW - case-based learning
KW - continuing medical education
KW - hospitalization
KW - substance use treatment
KW - substance-related disorders
UR - http://www.scopus.com/inward/record.url?scp=85090200446&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090200446&partnerID=8YFLogxK
U2 - 10.1007/s11606-020-06175-5
DO - 10.1007/s11606-020-06175-5
M3 - Article
C2 - 32885371
AN - SCOPUS:85090200446
VL - 36
SP - 100
EP - 107
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 1
ER -