Department of Epidemiology, School of Public Health, Brown University, Providence, RI (ABC, FLB), Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI (FLB, EAS, RW, JB), Department of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI (FLB).
J Addict Med. 2021;15(5):432-434. doi: 10.1097/ADM.0000000000000779.
To minimize the spread of COVID-19, health and ancillary care providers altered service delivery patterns. These changes included an increase in reliance on telemedicine modalities, a reduction in services or hours of operation, and prohibiting guests and nonessential personnel from healthcare settings. We describe a rapid environmental assessment with senior emergency department (ED) practitioners in Rhode Island to understand how COVID-related procedural changes impact the provision of post-overdose care in ED.
Semi-structured interviews were conducted with 14 senior healthcare practitioners in EDs across Rhode Island from June to July 2020. Interviews were part of a larger, ongoing study examining the implementation and effectiveness of post-opioid overdose care in EDs and sought to understand how COVID-19 had impacted the provision of services for people who use drugs (PWUD).
COVID-related policy changes challenged the provision of services to PWUD in the ED, and extended challenges in connecting people with OUD to services in the community. Specifically, challenges included transitions to telehealth modalities, required COVID tests for treatment services, and gaps in community resources.
This study underscores opportunities to improve the delivery of services amid overlapping public health crises for PWUD, including bolstering the use of telemedicine in EDs and across the care continuum.
为了最大限度地减少 COVID-19 的传播,医疗和辅助保健提供者改变了服务提供模式。这些变化包括增加对远程医疗模式的依赖、减少服务或运营时间,以及禁止访客和非必要人员进入医疗保健场所。我们描述了在罗德岛对高级急诊(ED)从业者进行的快速环境评估,以了解与 COVID 相关的程序变更如何影响 ED 中提供的过量用药后护理。
2020 年 6 月至 7 月,对罗德岛各地 ED 的 14 名高级医疗保健从业者进行了半结构化访谈。访谈是正在进行的一项更大研究的一部分,该研究旨在检查 ED 中阿片类药物过量后护理的实施情况和效果,并探讨 COVID-19 如何影响为吸毒者(PWUD)提供服务。
与 COVID 相关的政策变化挑战了 ED 中为 PWUD 提供服务的能力,并延长了将患有药物使用障碍的人连接到社区服务的挑战。具体而言,挑战包括向远程医疗模式的转变、治疗服务所需的 COVID 检测,以及社区资源的差距。
这项研究强调了在 PWUD 重叠的公共卫生危机中改善服务提供的机会,包括在 ED 和整个护理连续体中加强远程医疗的使用。