CQI action team: responding to the detoxification patient.

BACKGROUND

The management of detoxification patients is a complex interdisciplinary effort requiring involvement, cooperation, and understanding from staff at all levels of the facility. In 1992-93, alcohol-related diagnoses were the highest admission diagnosis at the Royal C. Johnson Veterans Affairs Medical Center (VAMC). Yet only 44% of the detoxification patients admitted to the VAMC were placed in beds specifically designed for detoxification. Initially, the action team believed that the issues were apparent and that the problems were the result of uncooperative and noncompliant providers who were not following established policy.

METHODS AND RESULTS

Data analysis of admission and discharge trends, laboratory results, and bed census revealed discrepancies with several widespread myths held by local health care workers. These misperceptions and attitudes often interfered with treatment.

CONCLUSIONS

Recommended changes included the development of a clinical pathway for the detoxification patient, implementation of an alcohol withdrawal assessment tool to manage and treat the patient at risk for experiencing alcohol withdrawal, and hospitalwide education on management of the detoxification patient.