Abstract：
BACKGROUND: The effectiveness of hospital-based transitional opioid programs (TOPs), which aim to connect patients with substance use disorders (SUD) to ongoing treatment in the community following initiation of medication for opioid use disorder (MOUD) treatment in the hospital, hinges on successful patient transitions. These transitions are enabled by strong partnerships between hospitals and community-based organizations (CBOs). However, no prior study has specifically examined barriers and facilitators to establishing SUD care transition partnerships between hospitals and CBOs.
OBJECTIVE: To identify barriers and facilitators to developing partnerships between hospitals and CBOs to facilitate care transitions for patients with SUDs.
METHODS: Qualitative study using semi structured interviews conducted between November 2022-August 2023.
METHODS: Staff and providers from hospitals affiliated with four safety-net health systems (n=21), and leaders and staff from the CBOs with which they had established partnerships (n=5).
METHODS: Interview questions focused on barriers and facilitators to implementing TOPs, developing partnerships with CBOs, and successfully transitioning SUD patients from hospital settings to CBOs.
RESULTS: We identified four key barriers to establishing transition partnerships: policy and philosophical differences between organizations, ineffective communication, limited trust, and a lack of connectivity between data systems. We also identified three facilitators to partnership development: strategies focused on building partnership quality, strategic staffing, and organizing partnership processes.
CONCLUSIONS: Our findings demonstrate that while multiple barriers to developing hospital-CBO partnerships exist, stakeholders can adopt implementation strategies that mitigate these challenges such as using mediators, cross-hiring, and focusing on mutually beneficial services, even within resource-limited safety-net settings. Policymakers and health system leaders who wish to optimize TOPs in their facilities should focus on adopting implementation strategies to support transition partnerships such as inadequate data collection and sharing systems.
OBJECTIVE: To identify barriers and facilitators to developing partnerships between hospitals and CBOs to facilitate care transitions for patients with SUDs.
METHODS: Qualitative study using semi structured interviews conducted between November 2022-August 2023.
METHODS: Staff and providers from hospitals affiliated with four safety-net health systems (n=21), and leaders and staff from the CBOs with which they had established partnerships (n=5).
METHODS: Interview questions focused on barriers and facilitators to implementing TOPs, developing partnerships with CBOs, and successfully transitioning SUD patients from hospital settings to CBOs.
RESULTS: We identified four key barriers to establishing transition partnerships: policy and philosophical differences between organizations, ineffective communication, limited trust, and a lack of connectivity between data systems. We also identified three facilitators to partnership development: strategies focused on building partnership quality, strategic staffing, and organizing partnership processes.
CONCLUSIONS: Our findings demonstrate that while multiple barriers to developing hospital-CBO partnerships exist, stakeholders can adopt implementation strategies that mitigate these challenges such as using mediators, cross-hiring, and focusing on mutually beneficial services, even within resource-limited safety-net settings. Policymakers and health system leaders who wish to optimize TOPs in their facilities should focus on adopting implementation strategies to support transition partnerships such as inadequate data collection and sharing systems.
摘要：
背景：基于医院的过渡性阿片类药物计划（TOPs）的有效性，其目的是在医院开始阿片类药物使用障碍（MOUD）治疗后，将患有药物使用障碍（SUD）的患者与社区正在进行的治疗联系起来，取决于成功的患者过渡。这些转变是由医院和社区组织(CBO)之间强有力的伙伴关系促成的。然而,之前没有一项研究专门研究了在医院和CBO之间建立SUD护理过渡伙伴关系的障碍和促进因素.
目的：确定医院与CBO之间发展伙伴关系的障碍和促进因素，以促进SUD患者的护理过渡。
方法：在2022年11月至2023年8月之间进行的使用半结构化访谈的定性研究。
方法：来自四个安全网卫生系统附属医院的工作人员和提供者（n=21），以及与他们建立伙伴关系的社区组织的领导人和工作人员(n=5)。
方法：面试问题侧重于实施TOP的障碍和促进者，发展与社区组织的伙伴关系，并成功地将SUD患者从医院转移到CBO。
结果：我们确定了建立过渡伙伴关系的四个关键障碍：组织之间的政策和哲学差异，无效的沟通,有限的信任，以及数据系统之间缺乏连通性。我们还确定了三个促进伙伴关系发展的人：以建立伙伴关系质量为重点的战略，战略人员配备，和组织伙伴关系进程。
结论：我们的研究结果表明，尽管发展医院与CBO伙伴关系存在多种障碍，利益相关者可以采取减轻这些挑战的实施策略，例如使用调解员，交叉招聘,注重互利服务，即使在资源有限的安全网设置。希望优化其设施的最高水平的政策制定者和卫生系统领导人应侧重于采取实施战略，以支持过渡伙伴关系，例如数据收集和共享系统不足。
目的：确定医院与CBO之间发展伙伴关系的障碍和促进因素，以促进SUD患者的护理过渡。
方法：在2022年11月至2023年8月之间进行的使用半结构化访谈的定性研究。
方法：来自四个安全网卫生系统附属医院的工作人员和提供者（n=21），以及与他们建立伙伴关系的社区组织的领导人和工作人员(n=5)。
方法：面试问题侧重于实施TOP的障碍和促进者，发展与社区组织的伙伴关系，并成功地将SUD患者从医院转移到CBO。
结果：我们确定了建立过渡伙伴关系的四个关键障碍：组织之间的政策和哲学差异，无效的沟通,有限的信任，以及数据系统之间缺乏连通性。我们还确定了三个促进伙伴关系发展的人：以建立伙伴关系质量为重点的战略，战略人员配备，和组织伙伴关系进程。
结论：我们的研究结果表明，尽管发展医院与CBO伙伴关系存在多种障碍，利益相关者可以采取减轻这些挑战的实施策略，例如使用调解员，交叉招聘,注重互利服务，即使在资源有限的安全网设置。希望优化其设施的最高水平的政策制定者和卫生系统领导人应侧重于采取实施战略，以支持过渡伙伴关系，例如数据收集和共享系统不足。
