Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, 08901, USA.
Heritage College of Osteopathic Medicine, The Institute to Advance Health Equity, Ohio University, 1 Ohio University, Athens, OH, 45701, USA.
J Gen Intern Med. 2024 Sep;39(12):2150-2159. doi: 10.1007/s11606-024-08883-8. Epub 2024 Jun 27.
The effectiveness of hospital-based transitional opioid programs (TOPs), which aim to connect patients with substance use disorders (SUD) to ongoing treatment in the community following initiation of medication for opioid use disorder (MOUD) treatment in the hospital, hinges on successful patient transitions. These transitions are enabled by strong partnerships between hospitals and community-based organizations (CBOs). However, no prior study has specifically examined barriers and facilitators to establishing SUD care transition partnerships between hospitals and CBOs.
To identify barriers and facilitators to developing partnerships between hospitals and CBOs to facilitate care transitions for patients with SUDs.
Qualitative study using semi structured interviews conducted between November 2022-August 2023.
Staff and providers from hospitals affiliated with four safety-net health systems (n=21), and leaders and staff from the CBOs with which they had established partnerships (n=5).
Interview questions focused on barriers and facilitators to implementing TOPs, developing partnerships with CBOs, and successfully transitioning SUD patients from hospital settings to CBOs.
We identified four key barriers to establishing transition partnerships: policy and philosophical differences between organizations, ineffective communication, limited trust, and a lack of connectivity between data systems. We also identified three facilitators to partnership development: strategies focused on building partnership quality, strategic staffing, and organizing partnership processes.
Our findings demonstrate that while multiple barriers to developing hospital-CBO partnerships exist, stakeholders can adopt implementation strategies that mitigate these challenges such as using mediators, cross-hiring, and focusing on mutually beneficial services, even within resource-limited safety-net settings. Policymakers and health system leaders who wish to optimize TOPs in their facilities should focus on adopting implementation strategies to support transition partnerships such as inadequate data collection and sharing systems.
医院为基础的过渡性阿片类药物项目（TOPs）旨在使接受药物治疗的药物使用障碍（MOUD）患者在医院启动治疗后与社区中持续治疗相连接，这些项目的有效性取决于患者的成功过渡。这些过渡是通过医院和社区组织（CBO）之间建立强有力的伙伴关系实现的。然而，以前没有研究专门探讨医院和 CBO 之间建立 SUD 护理过渡伙伴关系的障碍和促进因素。
确定医院和 CBO 之间建立伙伴关系以促进 SUD 患者护理过渡的障碍和促进因素。
使用半结构化访谈进行的定性研究，于 2022 年 11 月至 2023 年 8 月进行。
来自四家安全网健康系统附属医院的工作人员和提供者（n=21），以及他们已经建立伙伴关系的 CBO 的领导人和工作人员（n=5）。
访谈问题侧重于实施 TOPs、与 CBO 建立伙伴关系以及成功将 SUD 患者从医院环境过渡到 CBO 的障碍和促进因素。
我们确定了建立过渡伙伴关系的四个关键障碍：组织之间的政策和哲学差异、沟通不畅、有限的信任以及数据系统之间缺乏连接。我们还确定了建立伙伴关系发展的三个促进因素：注重建立伙伴关系质量的策略、战略人员配备和组织伙伴关系流程。
我们的研究结果表明，尽管存在建立医院-CBO 伙伴关系的多个障碍，但利益相关者可以采用实施策略来缓解这些挑战，例如使用调解人、交叉招聘和关注互利服务，即使在资源有限的安全网环境中也是如此。希望在其设施中优化 TOPs 的政策制定者和卫生系统领导者应专注于采用实施策略来支持过渡伙伴关系，例如数据收集和共享系统不足。
