Expand Treatment Team to Include Peer Support

EDs may use certified peer support specialists to connect patients presenting with substance use disorders (including opioid use disorder) to harm reduction, treatment, and recovery supports. Peers often have a way of engaging patients differently than other EPs; by offering their lived experience coupled with skilled training, peers help patients navigate services, referrals, and symptoms associated with their illness. In addition, peers may also help educate other clinicians about substance use disorders and their treatment. 

Based on data gathered by pilot sites for the NCHA ED Peer Support Pilot Project, the evidence is promising: within an 12 month reporting period, there was a 53% decrease in ED visits, 64% decrease in hospitalizations, and 37% decrease in 30-day readmissions compared to the year prior.  

Key Takeaways for the ED

  1. Work closely with your HR department to ensure hiring practices and policies support the hiring and retention of peer support specialists. For example, due to the criminalization of behavioral health conditions, some peers may have a criminal history that would automatically exclude their application.  
  2. Before the peer joins the treatment team, detail how patients will be flagged for a peer consult. We recommend a consult build within the EMR coupled with flagging patients’ symptoms and lab results that may indicate substance use.  
  3. For the peer model to be effective within EDs, peers must have strong champions. Consider a short list of physicians within the ED who will serve as a public champion for peers and educate others within the ED on their role, effectiveness, and integration into the treatment team. 
  4. Because peer supervision is often a different model than other clinical roles within the hospital, ensure the peer’s direct supervisor has received peer supervision training. Similarly, strong and consistent supervision is vital for peers due to the high-stress environment of the ED.  

Resources to Get You Started: 

Building the Case for Emergency Department Peer Support: Implementation Guide
This guide was developed by the North Carolina Healthcare Foundation and informed by the NC Emergency Department Peer Support Pilot Project six participating hospitals. (June 30, 2020)
Building the Case for Emergency Department Peer Support | Aug 4 2020
Slides (PDF)
Recording (YouTube)

NCHA convenes a virtual bi-monthly, peer-led, implementation group meetings for ED clinicians and administrators on topics from the ED Opioid Treatment Pathway. Here is the recording from the December implementation group call on this topic: Expanding the Treatment Team to Include Peer Support Specialists | Dec 16 2019
Slides (PDF)
Recording (YouTube)

NC Peer Support Specialist Certification Information 

Supervising Peer Support Specialists Training Course 

Peer Support Workers in Emergency Departments: Engaging Individuals Surviving Opioid Overdoses – Qualitative Assessment

Could Peer-Recovery Coaches Help Fight Drug Addiction Epidemic? 

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