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Who Needs Inpatient Detox? Development and Implementation of a Hospitalist Protocol for the Evaluation of Patients for Alcohol Detoxification
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Who Needs Inpatient Detox? Development and Implementation of a Hospitalist Protocol for the Evaluation of Patients for Alcohol Detoxification
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Journal Article
Who Needs Inpatient Detox? Development and Implementation of a Hospitalist Protocol for the Evaluation of Patients for Alcohol Detoxification
2014
Overview
ABSTRACT
BACKGROUND
Clinicians caring for patients seeking alcohol detoxification face many challenges, including lack of evidence-based guidelines for treatment and high recidivism rates.
OBJECTIVES
To develop a standardized protocol for determining which alcohol dependent patients seeking detoxification need inpatient versus outpatient treatment, and to study the protocol’s implementation.
DESIGN
Review of best evidence by ad hoc task force and subsequent creation of standardized protocol. Prospective observational evaluation of initial protocol implementation.
PARTICIPANTS
Patients presenting for alcohol detoxification.
INTERVENTION
Development and implementation of a protocol for evaluation and treatment of patients requesting alcohol detoxification.
MAIN MEASURES
Number of admissions per month with primary alcohol related diagnosis (DRG), 30-day readmission rate, and length of stay, all measured before and after protocol implementation.
RESULTS
We identified one randomized clinical trial and three cohort studies to inform the choice of inpatient versus outpatient detoxification, along with one prior protocol in this population, and combined that data with clinical experience to create an institutional protocol. After implementation, the average number of alcohol related admissions was 15.9 per month, compared with 18.9 per month before implementation (
p
= 0.037). There was no difference in readmission rate or length of stay.
CONCLUSIONS
Creation and utilization of a protocol led to standardization of care for patients requesting detoxification from alcohol. Initial evaluation of protocol implementation showed a decrease in number of admissions.
Publisher
Springer US,Springer,Springer Nature B.V
Subject
Advisory Committees - standards
/ Advisory Committees - trends
/ Biological and medical sciences
/ Clinical Protocols - standards
/ Desintoxication. Drug withdrawal
/ Health Services Needs and Demand - standards
/ Health Services Needs and Demand - trends
/ Humans
/ Medicine
/ Program Development - standards
/ Protocol
/ Psychology. Psychoanalysis. Psychiatry
