Attributes of Higher- and Lower-performing Hospitals in the Consult for Addiction Treatment and Care in Hospitals (CATCH) Program Implementation: A Multiple-case Study

Overview

Journal J Subst Use Addict Treat

Specialty Psychiatry

Date 2024 Sep 29

PMID 39343141

Authors

Elizabeth R Stevens

Adetayo Fawole

Yasna Rostam Abadi

Jasmine Fernando

Noa Appleton

Carla King

Medha Mazumdar

Donna Shelley

Charles Barron

Luke Bergmann

Samira Siddiqui

Daniel Schatz

Jennifer McNeely

Affiliations

Soon will be listed here.

Abstract

Introduction: Six hospitals within the New York City public hospital system implemented the Consult for Addiction Treatment and Care in Hospitals (CATCH) program, an interprofessional addiction consult service. A stepped-wedge cluster randomized controlled trial tested the effectiveness of CATCH for increasing initiation and engagement in post-discharge medication for opioid use disorder (MOUD) treatment among hospital patients with opioid use disorder (OUD). The objective of this study was to identify facility characteristics that were associated with stronger performance of CATCH.

Methods: This study used a mixed methods multiple-case study design. The six hospitals in the CATCH evaluation were each assigned a case rating according to intervention reach. Reach was considered high if ≥50 % of hospitalized OUD patients received an MOUD order. Cross-case rating comparison identified attributes of high-performing hospitals and inductive and deductive approaches were used to identify themes.

Results: Higher-performing hospitals exhibited attributes that were generally absent in lower-performing hospitals, including (1) complete medical provider staffing; (2) designated office space and resources for CATCH; (3) existing integrated OUD treatment resources; and (4) limited overlap between the implementation period and COVID-19 pandemic.

Conclusions: Hospitals with attributes indicative of awareness and integration of OUD services into general care were generally higher performing than hospitals that had siloed OUD treatment programs. Future implementations of addiction consult services may benefit from an increased focus on hospital- and community-level buy-in and efforts to integrate MOUD treatment into general care.

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