Benefits of peers in acute care settings

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Benefits of peers in acute care settings

Hospital administrators face pressure to improve quality metrics and patient outcomes while managing costs. Peer services deliver measurable improvements in clinical care, discharge planning effectiveness, and healthcare utilization.

Who are peers?

Peers are individuals who share life experiences with the patients they serve, such as substance use or mental health history. This lived experience helps them empathize, understand, and build rapport with patients. In health care, the title peer may refer to certified peer specialists or other positions designed to leverage lived experience, such as peer care navigators. Certification may be required for some of these positions.

The role of peers

Peers draw on lived experience to build credibility and trust with patients, breaking down barriers to engagement. Peers support patients by:


  • Serving as a trusted source of communication and advocate.
  • Translating medical information.
  • Providing self-help education and resources.
  • Supporting goal identification and recovery planning during key periods of motivation.
  • Sharing personal recovery stories to build connection and inspire hope.1

A peer workflow in acute care includes:

  • Identifying patients, for example, through electronic health record (EHR) consults or track board flags.
  • Screening.
  • Motivational interviewing.
  • Coordinating with nurses for discharge planning and post-discharge follow-up. 

In the ED, peer encounters are typically brief and focused on immediate needs and rapid discharge planning. In inpatient settings, peers can engage for longer periods with daily bedside visits and intensive transition planning over the course of the hospital stay.

Integrating peers delivers strong returns on investment by improving clinical outcomes, reducing health care burden, and increasing operational efficiency. These benefits directly support key administrative priorities and quality improvement initiatives. 

Benefits to health care systems and quality metrics

  • Reduced readmissions and acute care utilization2,3,4
    •  A multicenter study of over 10,000 emergency department (ED) patients showed peer-led interventions significantly reduced ED utilization from 83% to 50%. Overdose-related hospital events decreased from 7% to 4% in the six months following a peer-led intervention.5 
    •  Another study found a 44% decrease in hospitalizations and a 9% decrease in ED visits in the six months following peer engagement.6
  • Decreased opioid overdoses
    •  A large-scale study using Medicaid data from 70 hospitals found peer implementation was associated with 8.6% reduction in repeat medically treated overdoses.7
  • Increased initiation of medications for opioid use disorder (MOUD)
  • A study of over 3,000 hospitalized patients with opioid use disorder (OUD) found a 60.8% rate of successful outcomes (initiation of MOUD, referral, or treatment appointment) among patients with peer engagement, compared to 17.1% for those without.
  • Patients who saw peers were more likely to receive MOUD while admitted: 26.9% versus 6.7% for those who did not see a peer.8
  • Improved linkage to care, engagement, and retention for patients in substance use disorder treatment.9,10,11
  • Increased patient satisfaction scores through positive perceptions of care.12
  • Positive culture change across health care systems.13,14,15,16

Benefits of peers for clinical teams

  • Improve communication, trust, and shared decision-making between patients and care teams.17

    • In one study, over one third (38.9%) of peer-patient interactions resulted in new information being shared with the health care team.18
  • Support overwhelmed clinical staff during high-volume periods, including help with communication, discharge planning, and conflict de-escalation.
  • Peers model patient-centered interactions for clinical teams. 
  • Correct myths and decrease stigma about mental health and substance use disorders. 

Benefits of peers for patients

  • Better treatment outcomes, including increased initiation of MOUD and reduced substance use.19,20
  • Increased hope and activation for recovery.21
  • Comprehensive support such as goal setting, discharge preparation, care advocacy, medical information translation, and self-help education.

Implementation Resources

References

  • O'Neill M, Michalski C, Hayman K, et al. "Whatever journey you want to take, I'll support you through": a mixed methods evaluation of a peer worker program in the hospital emergency department. BMC Health Serv Res. 2024;24(1):147. Published 2024 Jan 30. doi:10.1186/s12913-023-10532-5

  • Randall MG, Horn BP, Crisanti AS. The Economic Effect of Peer Recovery Support Services: A Review of the Literature. Community Ment Health J. 2024;60(4):826-831. doi:10.1007/s10597-023-01212-z

  • Eddie D, Hoffman L, Vilsaint C, et al. Lived Experience in New Models of Care for Substance Use Disorder: A Systematic Review of Peer Recovery Support Services and Recovery Coaching. Front Psychol. 2019;10:1052. Published 2019 Jun 13. doi:10.3389/fpsyg.2019.01052

  • Lukacs T, Klein L, Bramante R, Logiudice J, Raio CC. Peer recovery coaches and emergency department utilization in patients with substance use disorders. Am J Emerg Med. 2023;69:39-43. doi:10.1016/j.ajem.2023.03.039

  • Nordeck CD, Oros M, Raley H, Smith S, Gryczynski J. Changes in hospital utilization following peer-led intervention for substance use disorders in hospital emergency departments. Am J Emerg Med. Published online May 28, 2025. doi:10.1016/j.ajem.2025.05.049

  • Magidson JF, Regan S, Powell E, et al. Peer recovery coaches in general medical settings: Changes in utilization, treatment engagement, and opioid use. J Subst Abuse Treat. 2021;122:108248. doi:10.1016/j.jsat.2020.108248

  • Treitler P, Crystal S, Cantor J, et al. Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose. JAMA Netw Open. 2024;7(3):e243614. Published 2024 Mar 4. doi:10.1001/jamanetworkopen.2024.3614

  • Tager A, Calderwood L, Crews C, Murphy A, Bowe A, Nazha H. Identifying factors associated with peer recovery coach interactions and successful outcomes for patients with opioid use disorder in Southern West Virginia. Am J Addict. Published online June 8, 2025. doi:10.1111/ajad.70052

  • Reuter QR, Santos AD, McKinnon J, Gothard D, Jouriles N, Seaberg D. Long-term treatment retention of an emergency department initiated medication for opioid use disorder program. Am J Emerg Med. 2022;55:98-102. doi:10.1016/j.ajem.2022.02.041 

  • Jennings LK, Lane S, McCauley J, et al. Retention in Treatment after Emergency Department-Initiated Buprenorphine. J Emerg Med. 2021;61(3):211-221. doi:10.1016/j.jemermed.2021.04.007

  • Tracy K, Burton M, Nich C, Rounsaville B. Utilizing peer mentorship to engage high recidivism substance-abusing patients in treatment. Am J Drug Alcohol Abuse. 2011;37(6):525-531. doi:10.3109/00952990.2011.600385 

  • Collins D, Alla J, Nicolaidis C, et al. "If It Wasn't for Him, I Wouldn't Have Talked to Them": Qualitative Study of Addiction Peer Mentorship in the Hospital. J Gen Intern Med. Published online December 12, 2019. doi:10.1007/s11606-019-05311-0 

  • Stack E, Hildebran C, Leichtling G, et al. Peer Recovery Support Services Across the Continuum: In Community, Hospital, Corrections, and Treatment and Recovery Agency Settings - A Narrative Review. J Addict Med. 2022;16(1):93-100. doi:10.1097/ADM.0000000000000810

  • Chen Y, Yuan Y, Reed BG. Experiences of peer work in drug use service settings: A systematic review of qualitative evidence. Int J Drug Policy. 2023;120:104182. doi:10.1016/j.drugpo.2023.104182

  • Cooper RE, Saunders KRK, Greenburgh A, et al. The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review. BMC Med. 2024;22(1):72. Published 2024 Feb 29. doi:10.1186/s12916-024-03260-y

  • Byrne L, Roennfeldt H, Wolf J, et al. Effective Peer Employment Within Multidisciplinary Organizations: Model for Best Practice. Adm Policy Ment Health. 2022;49(2):283-297. doi:10.1007/s10488-021-01162-2

  • Bédard K, Boisvert I, Rochette M, Racine E, Martel-Laferrière V. Exploring the value and acceptability of a patient navigator program for people who inject drugs and are hospitalized for bacterial infections: patients', community organization and healthcare workers' perspectives. BMC Infect Dis. 2025;25(1):221. Published 2025 Feb 14. doi:10.1186/s12879-025-10617-y

  •  O'Neill M, Michalski C, Hayman K, et al. "Whatever journey you want to take, I'll support you through": a mixed methods evaluation of a peer worker program in the hospital emergency department. BMC Health Serv Res. 2024;24(1):147. Published 2024 Jan 30. doi:10.1186/s12913-023-10532-5

  • Gertner AK, Roberts KE, Bowen G, Pearson BL, Jordan R. Universal screening for substance use by Peer Support Specialists in the Emergency Department is a pathway to buprenorphine treatment. Addict Behav Rep. 2021;14:100378. Published 2021 Sep 25. doi:10.1016/j.abrep.2021.100378

  • Reif S, Braude L, Lyman DR, et al. Peer Recovery Support for Individuals With Substance Use Disorders: Assessing the Evidence. Psychiatric services (Washington, DC). 2014;65(7):853-861. doi:10.1176/appi.ps.201400047

  • Austin EE, Cheek C, Richardson L, et al. Improving emergency department care for adults presenting with mental illness: a systematic review of strategies and their impact on outcomes, experience, and performance. Front Psychiatry. 2024;15:1368129. Published 2024 Feb 29. doi:10.3389/fpsyt.2024.1368129

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