Jefferson Announces Gift to Expand the Jefferson Addiction Multidisciplinary Service (JAMS)

Jefferson Health has received a $1.5 million gift from the Sheller Family Foundation to establish the Stephen and Sandra Sheller Consult and Bridge Pilot Program. Made possible by the generosity of Stephen and Sandra Sheller, who are committed to taking bold action to address the opioid crisis, the gift will greatly enhance the work of the Jefferson Addiction Multidisciplinary Service (JAMS) and improve patient engagement and success in recovery.

This pioneering program will be the first of its kind in Philadelphia, serving as a critical intermediary between acute hospital treatment and ongoing outpatient substance use disorder (SUD) treatment and programs. Concentrating services on the most vulnerable and in-need patients, this “one consult,” personalized addiction care program will be led by Drs. Lara Carson Weinstein, Rebecca Jaffe, Keira Chism, and Kory London. It will connect the services of tertiary care hospitals, starting in emergency rooms, with community systems designed to address long-term medical, behavioral, and social needs such as housing, legal assistance, and food insecurity, facilitating a compassionate handoff and transition into the community.

“There are a lot of factors already working against people fighting substance use disorder, and care can become fragmented between what happens in and outside a hospital setting,” said Rebecca Jaffe, MD, associate professor of medicine and division director of Hospital Medicine. “The Sheller Bridge Program is about engaging the patient when and where they need help, weaving together an array of services and providers both at Jefferson and in the community.”

Patients with SUD are extremely vulnerable to the challenges of acute hospitalization. While addiction care is historically an outpatient specialty, with over 15% of Americans struggling with an opioid use disorder, hospital admissions for patients with associated medical conditions are at an all-time high. Research illustrates that these patients face withdrawal, stigma, and isolation while in the hospital, all of which increase their risk of leaving the hospital against medical advice (AMA) before their treatment is complete. Upon discharge, many patients with SUD are lost to follow-up, and may relapse or even die before even reaching the next site of care. Over half require readmission for persistent or worsening infection, resulting in frequent visits to multiple hospital emergency rooms.

Jefferson will follow two avenues to tackle these issues: enhancement of their already established Consult Service and the creation of the Stephen and Sandra Sheller Bridge Program.

Episodes of inpatient care present an important opportunity for longer-term health benefits if managed optimally and in a trauma-informed way. The benchmark for addiction consult services addresses all biopsychosocial domains using a “one consult; personalized addiction care” model. The enhancement of Jefferson’s interprofessional SUD Consult Service will include peer support members, harm reduction experts, and social workers in addition to physicians from a range of specialties including psychiatry, medicine, and infectious disease among others.

This approach offers numerous benefits for patients, allowing JAMS to better identify those in need of SUD treatment when entering the hospital, to individualize treatment plans ensuring the right experts are working with patient at the right time, and to enable Jefferson to serve more patients and stay involved in their care for the duration of hospitalization—all decreasing care fragmentation.

“The patients with SUD that I work with are remarkably resilient in the face of ongoing trauma and life-threatening medical complications,” said Lara Carson Weinstein, MD, associate professor of family medicine and co-lead of the Program for Supportive Healthcare. “The Jefferson community has made significant progress in learning how to meet people who use drugs where they are, and support them in their recovery journey. However, up until now, the advanced treatment received during acute medical hospitalizations often could not continue post-discharge as there was no dedicated, easily accessible, outpatient space for people to receive ongoing comprehensive treatment for substance use disorders, complex medical and behavioral health conditions, and support addressing the social determinants of health.”

The Stephen and Sandra Sheller Consult and Bridge Program will function as a vital safe harbor for discharged patients in the earliest stages of medical and substance use recovery, serving those who have an incomplete encounter with the health system and building trust to support engagement or reengagement with traditional acute or outpatient care. It will also provide a mechanism to adequately address complex post-discharge care needs, particularly the 80% drug related increase in serious wound infections and amputations as a result of the addition of Xylazine in the drug supply. Establishing the region’s first Bridge Program has the potential to redefine addiction care in Philadelphia and perhaps nationally; creating a hub of innovation in the field and a model for other health systems to follow.

“We applaud Jefferson for thinking big with us, for acknowledging the importance of addressing gaps in SUD treatment care, and for stepping out to break down silos by working across institutions to have a greater positive impact to address the opioid crisis,” said Stephen Sheller on behalf of the family. “The addition of Fentanyl and Xylazine has reaped such devastation on not only individuals and families, but communities such as Kensington. The JAMS team at Jefferson has demonstrated a commitment, passion, and knowledge such that we cannot think of a better institution to take up this cause.”

As the region’s largest health system and safety net hospital for two-thirds of all Philadelphians—and with an institutional commitment to health equity—Jefferson is uniquely positioned to reimagine the standard of addiction care. These life-changing—and life-saving—new initiatives will not only optimize inpatient SUD care, but also improve patient engagement in recovery post-discharge, all through treatment customized to each individual.

Findings and resources will be shared throughout the Jefferson enterprise as well as with health systems across the region and beyond in the hopes of strengthening the program’s impact for patients, thereby helping to stabilize communities most impacted by this epidemic. Additionally, the JAMS team will work in a cross-institutional partnership with fellows participating in the JoAnne A. Epps Fellowship in Drug Policy and Substance Use Treatment through the Center for Public Health Law Research at Temple University’s Beasley School of Law, a program which is being simultaneously funded by the generosity and commitment of the Sheller Family Foundation. This innovative partnership aims to address the necessary changes in policy and law that are currently barriers to providing optimal care.

“We are incredibly grateful to the Sheller family for their vision, commitment, and generosity,” said Baligh R. Yehia, MD, president of Jefferson Health. “Their leadership in this space will enable us to reach more people in our communities. As we develop the infrastructure and protocols to reimagine a gold standard in SUD treatment, lives will be saved and the quality of life for Philadelphians will be improved.”