2022 Quality




Hospital Quality Improvement Showcase - Ascension Wisconsin

Recovery Coach 

In 2018, Ascension Wisconsin implemented a recovery coach program to provide peer support to patients presenting to the emergency department with substance use disorders (SUDs). Recovery coaches are trained professionals that have lived experience with substance abuse who have found their path to recovery.  

Since October 2018, recovery coaches have provided over 1,600 consultations in four Ascension Milwaukee area hospitals. The program's need has grown with the emergence of the COVID-19 pandemic; overdose deaths, particularly opioid-related deaths, have sharply increased over the past two years. To meet this continued need, Ascension Wisconsin is expanding the recovery coach program to all 10 hospitals covering the Fox Valley, Milwaukee and Racine communities beginning March 2022. This is one component of the system-wide opioid strategic plan to increase access to treatment and recovery services. 
Program expansion is possible because of multiple grant-funding sources, including the state opioid response grant, funded through the Substance Abuse and Mental Health Services Administration and the ED2 Recovery grant, funded through Wisconsin Voices to recovery. These grants provide recovery coach services to patients with opioid and stimulant use disorders. To ensure all patients have access to these services, the Ascension Wisconsin Foundations cover referral costs for those patients who don’t qualify under the grant terms. 

The recovery coach program is a collaborative effort among many disciplines, services and community partnerships. Emergency medicine physicians and nurses are the frontlines to recognize persons in crisis and initiate a recovery coach referral. Behavioral health collaborates with case management to create awareness of outpatient treatment programs, both internal or community-based, and facilitates referrals when needed. The recovery coach organization assists the patient to overcome barriers to recovery and help make connections to community resources to support recovery. 

Complementary to the recovery coach program are specific strategies aimed at treatment and recovery for persons with opioid use disorder (OUD). At Ascension St. Joseph Hospital, a multidisciplinary team of emergency department, chemical dependency, and family medicine specialists provide patients the opportunity to start treatment with buprenorphine while in the hospital. Since the start of this team, known as the buprenorphine or “B team,” in March 2021, 46 patients started treatment who may not otherwise sought treatment for OUD. Another strategy used at Ascension St. Joseph emergency department is giving naloxone kits free to patients at increased risk of opioid overdose. In 2021, 79 patients received free naloxone, while another 260 patients received a prescription for naloxone. The success of the free naloxone program has led to expansion to all Ascension Wisconsin hospitals beginning March 2022.  

Success is more than the number of patients treated; it is found in the compassionate care provided to persons who often feel stigmatized by their SUD. Success is also the life-changing stories of those we serve. The following story was shared by one of our emergency medicine providers. 
 
There is a patient the staff knows pretty well and is a “regular” in the emergency department. He was without a stable home and addicted to heroin. He would come to the ED often, especially on cold nights. He was extremely averse to talking about his health and usually left soon after eating a sandwich and warming up. A few months ago, he presented with back pain and a fever. He had an epidural abscess, a known complication of IV drug abuse. This is a life-threatening infection that needs emergent neurosurgery. He refused surgery and was going to leave the hospital. The need to use heroin during withdrawal is so strong that all he could think of was to get out of the hospital to use. Our recovery coach was able to talk to him; we talked about options for pain management, and he agreed to surgery. A few months later, I walked into a room to meet a patient that had cut himself while doing dishes. He said, “You know me. You took care of me a few months ago.” It was the same patient. He was transformed. He was happy, proud, looking me in the eye. He had been successful in avoiding opiates since the surgery. He had reunited with his family and was living with them. He was even caring for his sisters’ kids while she went to work. I don’t think my feet touched the ground for the rest of the shift.