This collection compiles research and implementation materials from the Improving Addiction Care Team (IMPACT) program from Oregon Health & Science University (OHSU). IMPACT is an interprofessional, hospital-based addictions team that provides addiction medicine consults to patients being treated at OHSU who have a substance use disorder (SUD). Hospitals treat many patients with complications from SUD such as endocarditis (inflammation of the heart lining), soft issue infections, and traumatic injuries, but most do not offer services or resources that address the underlying cause – the SUD itself. With IMPACT, inpatient medical and surgical providers and hospital social workers can refer patients with known or suspected SUD to receive services from the IMPACT team. Services include a comprehensive SUD assessment, a process to help the patient set patient-centered goals for their treatment, induction onto medication assisted treatment, direct connections to community based SUD treatment, and information about harm reduction strategies such as safe injection protocols, information about HIV prevention and prophylaxis, and education about naloxone for overdose referral.
This collection includes a summary of the research on IMPACT that has been published in peer-reviewed journals and references to those articles, a brief video explaining the program, a summary of the program from the American Hospital Association, and a number of implementation tools and hospital policies that support the IMPACT model that were previously published as an appendix to a 2019 article in the Journal of Addiction Medicine. The materials included in this collection are:
- A 4 page document that summarizes the IMPACT model and the research that has been published about IMPACT with references to peer reviewed journal articles
- A brief video explaining the program
- A program summary from the American Hospital Association
- An overview of medications to treat opioid use disorder (OUD) and alcohol use disorder
- A brief guide to managing opioid and alcohol withdrawal in the hospital
- The OHSU pharmacy and therapeutics policy on the use of medication to treat OUD in pregnant and non-pregnant patients
- A brief guide to the treatment of acute pain in patients with OUD
- The OHSU practice recommendations for patients undergoing surgery who take buprenophine for OUD
- A template for a comprehensive SUD assessment used by the IMPACT team
- A template for a social work assessment to determine the safety of discharging patients with a PICC line (peripherally inserted central catheter)
- A guide to convening and managing a patient care conference for discharge planning for patients receiving intravenous antiobiotic therapy upon discharge
- The OHSU patient safety care plan template used with IMPACT patients
- A template to prepare a relapse prevention plan
- A guide for educating patients about harm reduction strategies
- A sample letter used to communicate with parole and probation officers for patients who are involved in the justice system
- A template for medical notes on an initial inpatient addiction medicine consult
- A guide for informed consent conversations with patients about buprenorphine-naloxone and naltrexone medications
- A fact sheet about buprenorphine-naloxone (Suboxone)
Thanks to Dr. Honora Englander and her team at OHSU for letting us feature this collection.
Note: CLOUD cannot include proprietary journal articles in the library collection, so we and our partners work to prepare summaries of such research for inclusion in the library. We are actively reaching out to researchers and professionals who are working on opioid-related research and programs and requesting you to consider submitting materials to the library. Our hope is that we can bring more attention to the important work being done while providing our users with actionable, evidence-based information. For more information about clinician and researcher submissions, please click here.
Improving Addiction Care Team (IMPACT) – A Summary
Source: Dr. Honora Englander
The Improving Addiction Care Team, or IMPACT, is an interprofessional hospital-based addictions team that meets people with substance use disorder (SUD) during the reachable moment of hospitalization at Oregon Health & Science University.
Project IMPACT at OHSU
Source: Oregon Health & Science University
This 3 minute video describes Project IMPACT (Improving Addiction Care Team) operating at Oregon Health and Science University. The video includes program director Honora Englander, M.D., Melissa Weimer, D.O. and peer-recovery counselor O’Nesha Cochran.
Improving Addiction Care Team (IMPACT) Oregon Health and Science University (OHSU) – Case Study
Source: American Hospital Association
This case study describes the Improving Addiction Care Team (IMPACT) model developed at Oregon Health & Science University to provide addiction medicine consultations during inpatient hospitalization and provide transitions to community based substance use disorder treatment upon discharge.
Improving Addiction Care Team (IMPACT): Medications to Treat Substance use Disorders
Source: Dr. Honora Englander
This resource serves as a guide to beginning medication assisted treatment for individuals with opioid use disorder or alcohol use disorder in the hospital setting. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program, which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): OHSU Pharmacy and Therapeutics Policy on use of Medication to Treat Opioid Use Disorder (Pregnant and Non-Pregnant Patients)
Source: Dr. Honora Englander
This resource is Oregon Health & Science University’s pharmacy and therapeutics policy on the use of medications (methadone, buprenorphine, and naltrexone) for opioid withdrawal management or opioid maintenance therapy in patients with opioid use disorder who are hospitalized or seen in the emergency department.
Improving Addiction Care Team (IMPACT): Approach to Acute Pain Management in Patients with Opioid Use Disorder
Source: 2019
This resource is a guide to treating acute pain in individuals with opioid use disorder seen in the hospital setting. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): OHSU Practice Recommendations for the Perioperative Management of Patients on Buprenorphine-Containing Drugs
Source: 2018
This resource captures Oregon Health & Science University’s practice recommendations for the management of pain in patients on buprenorphine undergoing surgery and pregnant women during labor, delivery, and the post-partum period.
Improving Addiction Care Team (IMPACT): Template for ASAM SUD Assessment
Source: Dr. Honora Englander
This document provides a template for substance use disorder assessment as used by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): Social Work PICC Community Safety Assessment
Source: Dr. Honora Englander
This template is of a social work assessment for safe discharge of patients using a PICC line to receive medications used by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): Outpatient Parental Antibiotic Therapy
Source: Dr. Honora Englander
This resource serves as Project IMPACT’s guide to conducting a patient care conference to consider hospital discharge planning for patients receiving intravenous antibiotic therapy. This guide lists the steps for convening and conducting the conference and includes a meeting guide and note template.
Improving Addiction Care Team (IMPACT): Patient Safety Care Plan
Source: Dr. Honora Englander
This resource is a patient safety care plan for patients treated in this hospital who have substance use disorders. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): Template for Relapse Prevention Plan
Source: Dr. Honora Englander
This guide speaks with patients who use drugs about harm reduction strategies such as safe injection tips, HIV prevention and prophylaxis, and naloxone to treat opioid overdose. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program, which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): Approach to Harm Reduction
Source: Dr. Honora Englander
This resource serves as a guide to speaking with patients who use drugs about harm reduction strategies such as safe injection tips, HIV prevention and prophylaxis, and naloxone to treat opioid overdose. It is one of the protocols and tools developed for Oregon Health & Science University’s Improving Addiction Care Team (IMPACT) program which provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): Sample Letter to Parole & Probation Officer
Source: Dr. Honora Englander
This sample letter is for health care providers to send to parole and probation officers notifying them that an individual under supervision is being treated in the hospital and has been connected to substance use disorder treatment.
Improving Addiction Care Team (IMPACT): Template for Medical Provider Note on Inpatient Initial Addiction Consult
Source: Dr. Honora Englander
This document serves as a template for medical notes of the addiction consult provided by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT). IMPACT provides addiction medicine consultations to patients treated in the hospital who have a diagnosis of substance use disorder.
Improving Addiction Care Team (IMPACT): Medication Procedures, Alternatives, Risks and Questions
Source: Dr. Honora Englander
This document serves as a template for conducting informed consent (also known as PARQs – procedures, alternatives, risks and questions) for patients beginning medication assisted treatment with buprenorphine or naltrexone.
Improving Addiction Care Team (IMPACT): Fact Sheet buprenorphine-naloxone (Suboxone)
Source: Dr. Honora Englander
This resource is a fact sheet about buprenorphine-naloxone (Suboxone) used by Oregon Health & Science University’s Improving Addiction Care Team (IMPACT).