Introduction Alcohol-related medical admissions rise by 10% every year at The Hillingdon Hospitals NHS Foundation Trust, frequently readmitting patients to the medical wards. We sought to work collaboratively, crossing traditional boundaries between different care providers, to improve the quality of care provided to patients admitted with alcohol-related problems.
Methods Acute and community care providers worked with the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London to identify and overcome barriers to care and communication for patients with alcohol-related admissions to the medical wards at a District General Hospital. We employed a Psychologist with appropriate addiction and alcohol expertise as an Alcohol Specialist Practitioner (ASP). The role of the ASP was to: (1) educate, empower and support staff to better identify patients with alcohol problems deliver; (2) perform a comprehensive psychological assessment; (3) deliver psychological interventions; (4) encourage patient engagement with community alcohol services when assessed as appropriate; (5) measure outcomes as a result of service implementation. 103 medical inpatients (76 male; 27 female) were referred to the new inpatient service between 1 August 2011 and 31 December 2011. We compared the rate of engagement with alcohol services of the cohort referred to the ASP, to a cohort of 41 patients admitted to the Gastroenterology ward in 2010 with an alcohol-related admission, formally referred to alcohol services on discharge, by the Ward Manager. We studied the 30-day readmission rates between patients who did and did not engage with psychological interventions/community services. The Student's t-test was used for statistical analysis between groups.
Results 7 of the 103 patients referred to the service subsequently died as an inpatient, a further seven were abstinent at the time of referral. Analysis was performed on data from the remaining 89 patients. 69.5% of patients referred to the inpatient service engaged with the ASP and/or community alcohol services. This compares to an engagement rate of 15% with community alcohol services before the appointment of the ASP, (p 63% of those that declined the assessment/intervention of the ASP were readmitted within 30 days, significantly more than intervention group (p
Conclusion Employment of a Psychologist as an ASP on the medical wards significantly improved the subsequent engagement of patients with community alcohol services. Patients engaged with community alcohol services had a significantly lower rate of alcohol-related readmissions, compared to those who did not engage.
Competing interests None declared.
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