Yale New Haven Hospital
Reducing Readmission Rates for Opiate Addicts
Currently, prescription pain medication abuse, as well as heroin use, are growing epidemics in the United States.
How can we address this epidemic on a local scale, reducing readmission rates of addicts to Yale New Haven Hospital?
Researching
the
Problem
Roughly 21-29% of patients prescribed opioids for chronic pain misuse them
Between 8-12% develop an opioid use disorder
~4-6% who misuse prescription opioids transition to heroin
High rate of relapse related to neurobiological changes that accompany addiction
“40 to 60% of patients treated for addiction relapse within a year, and the rate is highest for tobacco addiction”
Onset, severity, and management of condition affected by interactions of biological and behavioral variables analogous to other chronic diseases
An individual’s treatment plan must be assessed continually and modified to ensure the plan meets the changing needs
Interviews
Interview One
Tony
Recovered addict,
volunteer
Marcie
Social Worker
Deidre
R.N. Nurse
Lynelle
Volunteer Recovery Program
Adam
M.D., Internal Medicine
From these interviews, we learned more about surgeries and drugs, sober houses, transportation to AA, volunteer calls, patient discharge after NARCAN, the problems of stigma and lack of education, and the significance of prior trauma plus mental health issues on opiate abuse.
Interview Two
Maureen
Recovered addict
“I did not think a recovery program was for me, and did not know how to change.”
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“I thought it was too late.”
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Marcie
Social Worker
TJ
Recovered addict,
volunteer
Sue
Son overdosed, partnering with U.S. Attorney’s Office
“Seeing patients is part of my healing.”
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“There are four main reasons people go to drugs: guilt, fear, bitterness, and rejection.”
“I had to Google what opiates were.”
From these interviews, we identified the core problems.
To focus our efforts, we wondered:
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How Can We ...
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… increase patient’s utility from the hospital’s program?
... adapt the treatment to each individual patient?
...catch risk factors and give support before a relapse/follow-up effectively after patients have been discharged?
...identify and target more at-risk groups?
Ideation
We reframed the problems, recognizing that our solution must:
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Streamline Volunteer Process
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Boost Morale
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Follow-up
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Education/Advocacy
Mandatory holding after ER visits
Boosting patient morale:
Group programs
Refilling the "spiritual battery": a space to do activities that help destress
Sharing success stories:
website, posters, pamphlets
Centralized resource catalogue:
A booklet of next steps
Sponsors' contact info
Housing, job resources
Prototypes
The Wristband
Need: To reduce the readmission rate of opioid addicts, we aimed to develop preventive solutions.
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Solution: A wristband, that every patient treated for opioid addiction can take with them when they begin out of hospital treatment.
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Aim: The wrist band has the phone numbers of local helplines and works as a constant reminder for patients that when they need help, these are resources they can reach out to immediately.
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Next steps: While our primary contact at New Haven Health is enthusiastic about usefulness of the wristband, our next step is to test the effectiveness of the solution. This means distributing wristbands at the hospital and following up on a sample of patients on their usefulness.
The Informational Takeaway
Need: To reduce the readmission rate of opioid addicts, we aimed to develop preventive solutions.
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Solution: A booklet that gives every patient treated for opioid addiction a range of tips and resources for recovery.
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Aim: The booklet has a wide range of different strategies for recovery. There is no one-size-fits-all answer for addiction recovery, so we provide information on multiple options that have helped individuals to recover
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Next steps: Similar to the wristband, we hope to eventually distribute booklets at the clinic and following up on a sample of patients on their usefulness.
Gallery
