Prevention of Unplanned Admissions for Patients Experiencing Acute Alcohol Withdrawal in the Emergency Department: Reviewing the Impact of a Hospital-Based Alcohol Care Team  

Arlene Copland*, Darren Quelch, Carol Appleyard, Sally Bradberry

*Corresponding author for this work

Research output: Contribution to conferencePosterpeer-review

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Abstract

Background.
Alcohol withdrawal (AWS) is a common presentation in many Emergency Departments (ED). There is a misplaced belief among some clinicians, that emergency admission for alcohol detoxification leads to long-term abstinence. This may in part stem from an absence of focused addiction education in pre-clinical curricula, leading to limited awareness when transitioning to clinical practice. Through implementation of an alternative management pathway, which empowers patients to drive their own recovery, the Sandwell and West Birmingham (SWB) Alcohol Care Team (ACT), aims to avoid unplanned emergency admissions for AWS. This is achieved through early review in ED (within one hour of referral) alongside a holistic assessment providing immediate outpatient support with elective admission for subsequent detox, with detox preparation sessions and post-detox support where appropriate.

Method
The following data were retrospectively collated from individuals presenting with AWS referred from ED to the ACT between 2018-2022: Number of patients assessed, Proportion (%) reviewed within one hour of referral, Number of admissions avoided, Reduction in proportion of (%) admissions relating to AWS requiring admission, Proportion of individuals abstinent at 1 year (%). The following were calculated: Number of unnecessary bed days avoided (assuming 4 bed days/admission averted), Estimated financial saving (1 bed day = £500).

Results
The SWB ACT assessed 2502 patients presenting to ED with AWS. Of these, 99.7% were seen within one hour of referral. ACT intervention prevented 497 AWS related admissions, equating to 1990 unnecessary ‘bed days’ and an estimated saving of £995,000. Admissions for those in AWS reduced by 59% and in excess of 25% of those supported by the ACT on an out-patient basis maintained abstinence for >1 year.

Conclusion
The SWB ACT approach to addressing unplanned alcohol admission and detox represents benefits for both the patient (sobriety and holistic support) and the hospital trust (costs).
Original languageEnglish
Publication statusPublished - 26 Sept 2023
EventRoyal College of Emergency Medicine Annual Scientific Conference Glasgow 2023 - UK, Glasgow
Duration: 26 Sept 202328 Sept 2023

Conference

ConferenceRoyal College of Emergency Medicine Annual Scientific Conference Glasgow 2023
CityGlasgow
Period26/09/2328/09/23

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