“ We ’ re still learning . I don ’ t think anybody who tells you that they ’ re dealing with this patient population will say they know everything about it . It ’ s a continuous process of education , and we constantly have to modify our approach to things .”
Dr . Abraham Lichtmacher Chief of Women ’ s Services
Intake is done via a screening questionnaire at the hospital ’ s clinic , so if a patient ’ s results present “ at risk ”, she may be confidentially and discreetly offered a variety of assistance options .
BUILDING A TRAINING PROGRAM FROM THE GROUND UP
Once the concept that would become G . R . A . C . E . was settled on , it was time to begin looking at the specific needs of addicted patients . That meant education for physicians and staff alike .
“ I would not say that we were experts in addictionmedicine treatment by any means ,” Dr . Lichtmacher says . “ I don ’ t think anybody is . We brought in national consultants who were involved in writing some of the current standards in terms of this type of patient management . We asked them what we needed to do — we wanted to know what would be required as far as infrastructure , staffing , and training . We put those pieces together until we had a good program running .”
Staff training in particular was a challenge , in large part because hospital staff in the labor and delivery areas were used to dealing with a variety of health issues around pregnancy , but not addiction , as a routine , co-presenting issue .
“ Many staff members , including physicians , who are not actively involved in dealing with this type of patient population felt uncomfortable ,” Dr . Lichtmacher recalls . “ Part of it was just the discomfort of not knowing what to do medically , and part of it was being unsure how to interact with this patient population .”
To confront the issue in a way that would provide a path forward and also lay the groundwork for future staff development , a sensitivity training around cultural competency in the addiction realm was created . The training discussed how to interact effectively with this patient population , as well as heightening the awareness of the issues these women faced as active addicts who also might be battling mental health issues , homelessness , and a roster of other issues . Dr . Lichtmacher was also quick to point out that this was just the beginning .
“ We ’ re still learning . I don ’ t think anybody who tells you that they ’ re dealing with this patient population will say they know everything about it . It ’ s a continuous process of education , and we constantly have to modify our approach to things . As an example , one of the things we found is that many of these patients have difficulties with transportation . We ’ re still struggling with the question of how to get patients to their treatment if they don ’ t have appropriate transportation .”