• J Addict Med · Mar 2020

    Alcohol Medical Intervention Clinic: A Rapid Access Addiction Medicine Model Reduces Emergency Department Visits.

    • Kimberly Corace, Melanie Willows, Nicholas Schubert, Louise Overington, Sean Mattingly, Eric Clark, Nathaniel Leduc, Brian Hutton, and Guy Hebert.
    • The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada (KC, MW, NS, LO); University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada (KC, MW, EC, GH); The Ottawa Hospital, Ottawa, Ontario, Canada (SM, EC, GH); University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada (KC, MW, LO, NL); Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (BH).
    • J Addict Med. 2020 Mar 1; 14 (2): 163-171.

    ObjectivesProblematic alcohol use accounts for a large proportion of Emergency Department (ED) visits and revisits. We developed the Alcohol Medical Intervention Clinic (AMIC), a Rapid Access Addiction Medicine (RAAM) service, to reduce alcohol-related ED re-utilization and improve care for individuals with alcohol problems. This article describes the AMIC model and reports on an evaluation of its impact on patients and the ED system.MethodsIndividuals presenting to The Ottawa Hospital Emergency Departments (TOH-ED) for an alcohol-related issue were referred to AMIC. Using data collected via medical chart review, and also self-report questionnaires, we assessed ED visits, revisits, and changes in alcohol use and mental health symptoms in patients before and after receiving services in AMIC. The incidence of alcohol-related ED visits and re-visits from 12-month periods before and after the introduction of AMIC were compared using data from TOH Data Warehouse. Connections made to additional services and patient satisfaction was also assessed.ResultsFor patients served by AMIC, from May 26, 2016 to June 30, 2017 (n = 194), there was an 82% reduction in 30-day visits and re-visits (P < 0.001). An 8.1% reduction in total alcohol-related 30-day TOH-ED revisit rates and a 10% reduction in total alcohol-related TOH-ED visits were found. After receiving AMIC services, clients reported reductions in alcohol use, depression, and anxiety (P < 0.001).ConclusionsAMIC demonstrated positive impacts on patients and the healthcare system. AMIC reduced ED utilization, connected people with community services, and built system capacity to serve people with alcohol problems.

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