Since the specialists joined RWJBarnabas, more patients are getting help for their substance use disorders. Of the 12,859 patients the peer recovery specialists saw in the first nine months of 2019, 89.1% accepted the services and 91.4% of those patients received services post discharge.
“It really speaks to great patient acceptance” of the program, said Nancy Holecek, chief nursing officer of the northern region at RWJBarnabas.
The program did reduce readmissions, she added. Of patients seen in July and August 2019, about 1 in 7 who accepted bedside Peer Recovery Program services had a 30-day ED revisit, compared with approximately 1 in 5 who declined the services.
More than 100 peer recovery specialists are employed by RWJBarnabas. A specialist is available 24/7 at all hospitals. They are alerted when a patient has been administered naloxone or buprenorphine, or if the patient screens as a high risk for a substance use disorder such as alcohol abuse. All patients in the emergency department and inpatient units are screened by nurses.
Peer recovery specialists enter the patient’s room at a vulnerable moment in their lives but can relate to them, said Angela Cicchino, a peer recovery specialist and supervisor of the program. “(We) can say, ‘I know exactly how it feels to be in this bed,’ ” she said.
Patients are typically open to speaking with the peer recovery specialist and discussing next steps to begin recovery. The specialist then calls in a clinical navigator, who works with the patient on a discharge plan, taking into consideration their insurance and social risk factors.
Even if the patient isn’t interested in discussing recovery options, the specialist calls the patient consistently after discharge and gives them a card with contact info. “Now they know there is help out there,” Cicchino said. “Eventually something is going to happen, and if we can plant the seed, they remember us; that is really what we look to do.”
For patients who agree to get treatment after departing the hospital, the specialist calls them three times the first week, twice the second week and once a week for six more weeks. The calls then taper off to once every three months. The specialist is mainly checking in with the patient to see how their recovery is going. Once a week each hospital site also hosts gatherings for patients and their family members to discuss their experiences with recovery. Families are thankful for the program, Cicchino said.
Clinical staffers also appreciate the peer recovery specialists, Holecek said. “We didn’t have the understanding about the disease in such a deep way, we didn’t have the resources” before the peer recovery program, she said.
The grant will end in September 2020, but Greene said the system plans to keep the program going. The state has approved including peer recovery specialists as a reimbursable service in its Medicaid program, which will help with funding.