Royal Alex sees success aiding vulnerable patients
An innovative three-year pilot program for heavy users of the Royal Alexandra Hospital’s emergency department — patients struggling with drug use, poverty and homelessness — is showing positive results, organizers say.
The Inner City Health and Wellness Program has seen more than 600 patients since its launch last July, said Dr. Karine Meador, the program’s assistant director.
“If somebody comes in with frostbite, the hospital and medical team is very good at treating that frostbite. But what our team is looking to do is go a step back and say, ‘why did you get frostbite? Is it because you’re homeless? How do we prevent that’?” Meador said.
The clinical arm of the program, called the Addiction Recovery Community Health (ARCH) team, includes Meador, other doctors, a nurse practitioner, a social worker, and soon, an addictions counsellor. There’s also education and research components.
A bright red door adorned with inspirational messages in the ARCH office at the Royal Alex is a symbol of what the program is all about. There’s no wrong door for patients to walk through, said Meador. They may have entered the door to the emergency department when what they really need is help with housing, but the ARCH team will connect them with the right resources.
Program director Dr. Kathryn Dong said staff have made huge gains over the past year in their work with patients facing substance use disorders and homelessness.
“We’ve worked really hard on relationship-building and trust and creating a safe place at the Alex to talk about substance use. Then our team, having the skills that they do in addiction medicine, is able to intervene and offer evidence-based treatments that we weren’t able to offer before.”
George Buchan,5 4, who has lived on the streets for decades, was referred to ARCH after a visit to the emergency department in April for opiate withdrawal.
The nurse practitioner he talked to was different, Buchan said.
“Her questions weren’t leading up to kicking me out or cutting me off,” he said. “They were leading up to helping me.”
He now visits ARCH’s outpatient clinic in the hospital’s community services centre. Buchan is focused on ending his drug use or, in his words, “retiring from this stuff.”
“A 22-year addiction, it ain’t going to go away quick,” he said. But he’s buoyed by the medical help from ARCH, alongside assistance with other issues, such as getting ID. Team members, with their bright orange lanyards, are becoming recognized by patients. Those connections are important to the program’s success, Meador said. Previously, patients might see different workers each time they went to the hospital, but there is now continuity between visits.
Meador describes a young woman whose intravenous drug use led to numerous trips to the hospital. Initially, the woman was angry and unwilling to engage. But Meador built a relationship over several visits, and the woman now recognizes the doctor when she comes into the room. The woman was connected with addictions treatment in the community, and provided with naloxone training — an antidote proven to reverse the effects of opioid overdoses.
“She has come back to us to get more naloxone, because she has used what we provided her. That, to me, is a huge success,” Meador said.
The pilot is funded with $3.5 million from the Royal Alexandra Hospital Foundation.
Andrew Otway, CEO of the foundation, said he has been “incredibly impressed” by the program’s work so far. “They’ve had amazing results in a very short period of time.”