Navigating Addiction Care in the Emergency Department

Beckie Deo

Putting it lightly, receiving and paying for health care in America can be complex. Questions of insurance, confusing medical bills, and understanding why, when, and where and when to go for medical care can all stand in the way of people receiving the care that they need. That’s where patient navigators step in. 

These navigators don’t point patients toward any one destination. Instead, they work one-on-one with patients to spot any issues that might get in the way of those patients receiving care and find solutions to overcome or work around those challenges. 

Navigators help patients throughout Cooper University Health Care, but within the Center for Healing, Cooper’s Division of Addiction Medicine, a team of navigators is dedicated entirely to patients in the Emergency Department. These navigators are on hand to help those in the ED with substance use disorders and connect them with all the available support they are ready for. 

Beckie Deo leads these patient navigators stationed in Cooper’s Emergency Department. In this Q&A, learn more about what they do and why stigma can be as daunting a barrier to care as anything else. 

What does your team of navigators in the ED do for patients? 

All patients in the ED are screened using the National Institute on Drug Abuse (NIDA) quick screening, and the results of that may put them on our radar. My team will then meet with each patient whose screen indicated a possible substance use disorder and see if they're interested in treatment services. 

If the patient is interested in detox or residential rehab, the navigator will sit bedside with them and call nearby facilities. Then, if the patient has been accepted into one, the navigator will connect them with transportation, clothing, and food, and the navigator will give them a contact number so they can keep in touch. 

If a patient declines, we provide them with information about local resources, food, and clothing, and they also get a contact number for us should they need us in the future. If a patient also has wounds, we’ll provide them with a premade wound kit to encourage healing. 

We’ll also schedule outpatient addiction appointments with them in real time, so they leave the ED knowing what the next step in their care is. 

Another important job for these navigators is to advocate for these patients. They fight any stigma across the healthcare landscape and build rapport with patients so that when the patients are ready to seek treatment, they’ll know they have people they trust to call on. 

Why is it important to have patient navigator positions in the ED? 

Our ED navigators are often the first people in the emergency department that patients have conversations with around substance use. This is often a wholly different and more vulnerable issue than what brought them to the hospital in the first place. 

They build relationships with people who may have lost a lot of trust in the health care system. Our navigators make the ED a place that is welcoming for all patients to receive care. 

Why is the ED an important ally in addiction medicine? 

In the ED, we often see people at their worst. We’re able to make them feel welcome and connect them with services including our own outpatient offices. That gives us the ability to complete warm handoffs to others in our addiction medicine department, which creates a sense of trust and security for the patient. 

It also helps when we can come over to our outpatient locations and see how the patients are doing, which always helps our patients know we haven't forgotten about them. 

What makes a great patient navigator? 

A patient navigator should be someone who doesn't give up on a person despite the outcomes. Someone who is empathetic and does not judge. Someone who comes from a place of care and love at all times. 

For a health system interested in improving addiction care in the ED, what advice would you offer? 

All staff should complete mandatory training on patient-centered ways to work with people with an SUD. Training topics should include trauma-informed care and language to reduce stigma. 

Addressing stigma in the emergency department is crucial for ensuring that individuals with mental health or substance use issues are treated appropriately. People should not be made to feel guilt or shame when they ask for help. Those feelings keep them away from the care they need and deserve, which can negatively impact their well-being overall. 

What do you like most about your role overseeing our ED navigators? 

I’m in recovery myself, and when I was in active addiction, I was mistreated in an ED. I know how it feels. I love that I get to be a part of the change, and I get to be there for others in a way I wish others were there for me when I was begging for help.