Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15th Ave NE, Fourth Floor, 98195 Seattle, WA, USA.
Research with Expert Advisors on Drug Use, University of Washington, Seattle, WA, USA.
Int J Drug Policy. 2023 May;115:104005. doi: 10.1016/j.drugpo.2023.104005. Epub 2023 Mar 25.
As Supervised Consumption Sites (SCS) are implemented in the United States, it is important to consider the needs and perceptions of impacted stakeholders. Emergency service providers (ESP) have a central role in responding to the overdose epidemic. This study intended to assess the how ESP perceive the potential implementation of an SCS in their community, as well as solicit program design and implementation-related concerns and suggestions.
In-depth interviews were conducted by videoconference with 22 ESP, including firefighters, paramedics, police, and social workers in King County, Washington, USA. Data were analyzed using a thematic analysis approach.
Participants expressed the importance of feeling safe while responding to calls where drug use is involved and highlighted how this perception would be linked to ESP response times to calls from an SCS. Suggestions for improving the perceived safety of an SCS included training program staff in de-escalation as well as planning the layout of the SCS to accommodate ESP. The inadequacy of the emergency department as a point of care for PWUD was also identified as a theme, and some participants expressed enthusiasm regarding the prospect of the SCS as an alternative destination for transport. Finally, support for the SCS model was conditional on the appropriate utilization of emergency services and a reduction in call volume. Participants listed clarifying roles and pursuing opportunities for collaboration as ways to ensure appropriate utilization and maintain positive working relationships.
This study builds on literature regarding stakeholder perceptions of SCS by focusing on the perceptions of a critically important stakeholder group. Results enhance understanding of what motivates ESP to support SCS implementation in their community. Other novel insights pertain to ESP thoughts about alternative care delivery models and strategies for emergency department visit diversion.
随着美国监督消费场所（SCS）的实施，考虑受影响利益相关者的需求和看法非常重要。紧急服务提供者（ESP）在应对过量用药流行方面发挥着核心作用。本研究旨在评估 ESP 如何看待在其社区中潜在实施 SCS，并征求与项目设计和实施相关的关注和建议。
在美国华盛顿州金县，通过视频会议对 22 名紧急服务提供者（包括消防员、护理人员、警察和社会工作者）进行了深入访谈。使用主题分析方法对数据进行分析。
参与者表示，在回应涉及吸毒的电话时感到安全非常重要，并强调了这种看法将如何与 ESP 对来自 SCS 的电话的响应时间联系起来。为提高 SCS 感知安全性的建议包括培训计划工作人员的缓解技能，以及规划 SCS 的布局以容纳 ESP。还确定了将急诊室作为药物使用障碍者的护理点的不足是一个主题，一些参与者对 SCS 作为运输替代目的地的前景表示热情。最后，对 SCS 模型的支持取决于紧急服务的适当利用和呼叫量的减少。参与者列出了明确角色和寻求合作机会的方法，以确保适当利用并保持积极的工作关系。
本研究通过关注一个至关重要的利益相关者群体的看法，扩展了关于利益相关者对 SCS 看法的文献。结果增强了对促使 ESP 支持其社区中 SCS 实施的动机的理解。其他新颖的见解涉及 ESP 对替代护理提供模式的想法和急诊部门就诊分流的策略。
