Because of hospital staff turnover, educating line staff
is an ongoing process. There's also the challenge of
being a mobile unit working among three hospitals,
especially in scheduling adequate coverage and
transporting records. Currently, an ARMOT staff member is
present in the hospital from 8:00 a.m. to 4:00 p.m.
Patients entering the hospital at night might not be
willing to wait until 8:00 a.m. the next day to speak
with an ARMOT employee.
To address this barrier, two additional staff were added
to the ARMOT program. These staff members work in the
hospitals Monday through Friday from 3:00 p.m. to 11:00
p.m. and from 12:00 p.m. to 8:00 p.m. on the weekends.
Adding the evening/weekend staff has really helped with
better patient engagement, and the number of patients who
are discharged prior to meeting with ARMOT staff has
HIPAA regulations can make sharing patient information a
challenge as well. Hospitals invited ARMOT staff to new
employee orientations so they could become familiar with
confidentiality policies. ARMOT staff are considered
sub-contracted volunteers with the three hospitals,
giving them minimal but sufficient access to each
hospital's electronic medical records.
Stigma around substance use disorders can be a barrier
when implementing a program like this. Education is
important to help understand the patient population whom
program coordinators are trying to reach. The use of peer
Certified Recovery Specialists has been vital to the
program's success, helping with both patient engagement
and education of hospital staff on addiction and
Some doctors in the three hospitals' emergency
departments were hesitant about utilizing buprenorphine
to treat withdrawal symptoms, but ARMOT has been able to
increase the number of physicians in the emergency
department willing to use buprenorphine to treat opioid
The COVID-19 pandemic has created additional barriers for
patients accessing treatment services. ARMOT had to
utilize telehealth more often when staff members were not
allowed in the hospitals. It's also been challenging to
find treatment facilities that will accept a patient
coming from a hospital and to coordinate transportation.
Hiring and retaining staff to work within the program has
been a challenge over the past couple of years,
especially the positions that work evenings and weekends.
When those positions fill, staff opt to move into a
daylight position when one is available. To address this
challenge, ARMOT added an increased hourly rate for staff
who work in the evenings and on weekends.