Lindenfeld Zoe, Franz Berkeley, Lai Alden Yuanhong, Pagán José A, Fenstemaker Cheyenne, Cronin Cory E, Chang Ji Eun
Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, 08901, USA.
Heritage College of Osteopathic Medicine, Ohio University, 1 Ohio University, Athens, OH, 45701, USA.
Addict Sci Clin Pract. 2025 Apr 24;20(1):37. doi: 10.1186/s13722-025-00565-y.
Programs that aim to increase access to substance use disorder (SUD) treatment in hospital-based settings have proliferated in recent years. These efforts include transitional opioid programs (TOPs), which navigate patients to community-based SUD treatment programs post-discharge. Successful navigation from TOPs to outpatient treatment hinges on effective coordination between hospitals and post-discharge endpoints, yet it is unclear how hospitals can best develop effective partnerships with outpatient treatment organizations. The objective of this study is to synthesize the common themes underpinning the development of partnerships to facilitate care transitions between TOPs and ongoing SUD treatment.
Qualitative study with staff and providers from hospitals affiliated with four safety-net health systems (n = 21) and leaders from community-based organizations (CBOs) and treatment facilities that had established referral partnerships with one of the four health systems in our study (n = 4).
Analysis of interview transcripts revealed seven common themes that underpinned the development of care transitions partnerships: (1) Active, intentional outreach; (2) Responding to a community need; (3) External Enabling Factors; (4) Leveraging reputations and community connections; (5) Focusing on operations; (6) Reciprocal relationships; and (7) Building Infrastructure and Processes to Ensure Collaboration. The seven identified themes were categorized into three groups corresponding to different partnership development stages. The first group revolves around the initial stage of meeting and developing a relationship (themes #1-4). The second set focuses on navigating and resolving challenges that arise in the partnership (themes #5-6). Lastly, the third group pertains to sustaining a partnership long-term (theme #7).
This study identifies seven core themes underlying the development of care transition partnerships for SUD patients within four safety net health systems and their CBO partners. These themes demonstrate how partner organizations can establish the trust, reciprocity, and commitment necessary to support patients through the critical transition period.
近年来，旨在增加医院环境中物质使用障碍（SUD）治疗可及性的项目大量涌现。这些举措包括过渡性阿片类药物项目（TOPs），该项目在患者出院后将其引导至基于社区的SUD治疗项目。从TOPs成功过渡到门诊治疗取决于医院与出院后终点之间的有效协调，但尚不清楚医院如何才能最好地与门诊治疗组织建立有效的合作关系。本研究的目的是综合支撑合作关系发展的共同主题，以促进TOPs与持续的SUD治疗之间的护理过渡。
对来自四个安全网卫生系统附属医院的工作人员和提供者（n = 21）以及与我们研究中的四个卫生系统之一建立了转诊合作关系的社区组织（CBOs）和治疗机构的领导者进行定性研究（n = 4）。
对访谈记录的分析揭示了支撑护理过渡合作关系发展的七个共同主题：（1）积极、主动的外展；（2）响应社区需求；（3）外部促成因素；（4）利用声誉和社区联系；（5）关注运营；（6）互惠关系；（7）建立基础设施和流程以确保合作。确定的七个主题分为三组，分别对应不同的合作关系发展阶段。第一组围绕建立关系的初始阶段（主题1 - 4）。第二组侧重于应对和解决合作关系中出现的挑战（主题5 - 6）。最后，第三组涉及长期维持合作关系（主题7）。
本研究确定了四个安全网卫生系统及其CBO合作伙伴之间为SUD患者建立护理过渡合作关系的七个核心主题。这些主题展示了合作伙伴组织如何建立信任、互惠和承诺，以在关键的过渡时期支持患者。
