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Emergency Department Impact Spotlight​

Hope as a Strategy: How Union Hospital Built a Peer Support ​​​Program Rooted in Trust

Published
August 31, 2026
Facility
ChristianaCare Union Hospital
Region
Upper Eastern Shore
Featuring
Lisa Fields, Cecil County Community Health Education, Union Hospital

Tagged

  • Upper Eastern Shore
  • ​ Identification and engagement​​ 
  • ​ ​​Initiation/continuation of addiction medications​

Inclusion is not an endorsement

The Maryland Department of Health shares this account to highlight practices other facilities may find useful. Appearing in this series is not an endorsement, recommendation, certification, or approval of any hospital, health system, provider, vendor, or program by the Maryland Department of Health or the State of Maryland. Descriptions and figures are provided by the participating facility.

“Sometimes it’s about taking off your badge and saying, I want you to see me as a person. Healthcare is hard. Sometimes we just need to see each other as who we are as humans and connect as humans.”

— Lisa Fields, ChristianaCare Union Hospital

Lisa Fields was born at ChristianaCare's Union Hospital. She was raised in the surrounding Cecil County community and she has worked at the hospital for 29 years. So when she talks about roots, she means it. Her deep-rooted sense of belonging is the first clue to why the recovery program she helps lead is a model for other Maryland hospitals.

Today, Fields manages the Cecil County Community Health Education program, which includes a bi-monthly community education series that invites providers throughout the county and physician leadership. When the role opened four years ago, her heart pulled her toward it. The very first project waiting for her was the hospital's peer support program for substance use disorder (SUD) and it became, in her words, her purpose. "I get my cup filled every day," she says. "I love seeing the impact that they make."

In 2022, the county's overdose fatality rate was more than double Maryland's statewide rate and well over twice the national rate. Union Hospital had quietly offered peer support for more than 15 years. It was so quiet that Fields, a 29-year veteran, didn't know it existed until she stepped into her current role.
A 2023 grant changed everything, allowing the hospital to expand peer services from weekday business hours to seven days a week, 8 a.m. to 1 a.m., and to add a 24/7 "CATCH line" so caregivers always have someone to call. The peers are staffed in partnership with the Cecil County Health Department on weekdays and Voices of Hope—a peer-led recovery community organization—on evenings and weekends. Two entities, walking into the hospital as one care team.

Bringing the Peer onto the Care Team

The expansion gave Union Hospital more peers. The breakthrough was deciding they weren't visitors—they were colleagues. Fields worked to embed peers directly into the daily case management and social work huddles, pairing them with social workers so that clinical expertise and lived experience sat at the same table. "They don't belong apart," she says. "They have to be together to look at the whole person."

The effect was immediate. Amid chronic staffing shortages, peers lifted a massive burden off social workers' caseloads while bringing something no credential can teach—lived experience. Just as importantly, the hospital began treating patients with MOUD, a service Union previously lacked. Before this shift, patients in early withdrawal would self-discharge prematurely because the hospital offered no OUD treatment. Now, MOUD can stabilize these patients long enough for peers to reach them and link them to community-based treatment. To win over a skeptical emergency department and medical floor, Fields turned to storytelling. Because hospital staff regularly see patients return four or five times—but rarely see the one who finally enters recovery—the team began sharing anonymous success stories and patient thank-you cards. "Sharing those success stories is so important," Fields says, "so that they have the hope that the work that they're doing makes a difference." Hope, it turns out, serves as an implementation strategy. 

Fields is careful to credit Dr. Gregory Warner and Dr. Arsalan Sheikh, the campus's chief medical officer, who put boots on the ground to make colleagues comfortable with initiating patients with treatment using medications for opioid use disorder (MOUD). When stigma surfaced, the most was technical assistance from a clinician with the Maryland Addiction Consultation Service (MACS) in front of another clinician.

Extending the Warm Handoff Beyond the ED

A peer is only as effective as the door they can open next. So Fields built outward. The hospital formed partnerships with independent treatment centers—so a discharged patient leaves with an appointment, a ride, and a clinical bridge already in place to continue MOUD treatment and other care. Peers were also connected to the hospital's own primary care practices. When a clinician identifies a patient who needs help, a peer can walk straight over for a private consultation, catching people before they ever reach the emergency department. That pathway alone has produced about a dozen success stories.
The results speak volumes: in fiscal year 2024, the program assisted more than 600 patients, with 440 connected to MOUD and other treatment options.

A Message For Other Hospitals​

​Fields keeps a story close—a boy on a beach throwing stranded fish back into the ocean, one at a time. Told he'll never save them all, he picks up another and says, "I saved that one." It is, she says, how she thinks about every patient. "Every life makes a difference. Every life."

Her advice to hospitals facing challenges launching new programming comes down to a sequence: clear the stigma by sharing real stories, get physician leadership visibly behind MOUD, lean on clinician-to-clinician education (like MACS), and build genuine partnerships with the community treatment centers that can reach patients after discharge. She'd add one ask for policymakers. In Maryland, peer services still aren't reimbursable in a hospital setting, leaving programs like hers dependent on grants which isn’t a sustainable funding model. 

"Everything that I have led that has been successful starts with trust and relationship," she says. And trust, in her telling, often begins with a small, human act. "Sometimes it's about taking off your badge and saying, I want you to see me as a person. Healthcare is hard. Sometimes we just need to see each other as who we are as humans and connect as humans."

If you put in the effort and build that trust, Fields promises, the rest follows. "There will be success stories, and you will make an impact. It will happen."

By the numbers
  • 600+patients assisted in fiscal year 2024, with 440 connected to MOUD and other treatment options
  • 82.0per 100,000 residents — Cecil County’s 2022 overdose fatality rate, against 40.3 statewide and 34.6 nationally
  • 7 daysof peer coverage each week, 8 a.m. to 1 a.m., plus a 24/7 “CATCH line”

Figures reflect what the interviewee reported and are provided by the participating facility.

What other Maryland hospitals can take away

  • Clear the stigma by sharing real stories. Remember the boy on a beach throwing stranded fish back into the ocean, one at a time. Told he’ll never save them all, he picks up another and says, “I saved that one.” It is, she says, how she thinks about every patient. “Every life makes a difference. Every life.”
  • Get physician leadership visibly behind MOUD, and lean on clinician-to-clinician education, like MACS.
  • Build genuine partnerships with the community treatment centers that can reach patients after discharge.
  • Start with trust. “Everything that I have led that has been successful starts with trust and relationship,” she says. If you put in the effort and build that trust, Fields promises, the rest follows: “There will be success stories, and you will make an impact. It will happen.”

More impact spotlights

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