Table 1.
Types of implementation strategies used by a national sample of nonprofit hospitals (N = 446) to address opioid abuse, United States, 2015-2018a
| Category | Description | Examples |
|---|---|---|
| Clinical approach | ||
| Substance use disorder treatment | Programs that support hospital-based or external services to treat substance use disorders | Increasing the number of available health care providers; improving access to MAT; providing financial assistance to patients for inpatient substance abuse services |
| Primary care | Programs that support access to services in the primary care setting | Implementing substance abuse screening in primary care in general and for special populations (eg, pregnant women); helping patients connect with a primary care medical home; supporting behavioral health and primary care integration |
| ED services | Programs that are run primarily in the ED | Providing educational resources at discharge; distributing drug lockboxes; offering pain management consultations; researching needs of patients using the ED for conditions related to substance abuse; screening in the ED; hiring a full-time behavioral health provider for the ED; initiating MAT in the ED |
| Nonclinical | ||
| Harm reduction | Programs that aim to prevent overdose and secondary infections from intravenous drug use | Syringe exchange programs; naloxone distribution in the ED; supplying police with naloxone |
| Prescriber initiatives | Programs that seek to improve prescribing practices | Prescriber guidelines; prescription drug monitoring programs |
| Risk education | Programs that provide preventive education to general and special populations | Populations included schools, seniors, health care professionals, and parents; other initiatives include medication take-back events and stigma reduction workshops |
| Social determinants | Programs that explicitly address health disparities and/or the health outcomes of underserved populations | Initiatives to reduce toxic stress; substance abuse screening for underserved populations; cultural competence training for substance abuse service providers; programs for homeless patients |
| Policy advocacy | Programs that support policy change at the local, state, or federal level | Advocating for prevention funding; criminal justice reform; statewide public health prioritization of substance abuse; full implementation of behavioral health parity legislation |
| Community coalition building | Programs that facilitate collaboration with public health and behavioral health treatment providers in the community | Providing financial support for community coalitions; facilitating community-wide meetings; supporting coalitions aimed at improving health care access; establishing a health advisory council; partnering with the local health department |
Abbreviations: ED, emergency department; MAT, medication-assisted treatment.
aData were collected from community health needs assessments and implementation strategies described on hospital websites and, when necessary, by contacting the hospital directly.