Models for implementing ED-initiated buprenorphine with referral for ongoing medication treatment at ED discharge in diverse academic centers

• Published in: Annals of emergency medicine 2022-06, Vol.80 (5), p.410-419
• Main Authors: Whiteside, Lauren K., D’Onofrio, Gail, Fiellin, David A., Edelman, E. Jennifer, Richardson, Lynne, O’Connor, Patrick, Rothman, Richard E., Cowan, Ethan, Lyons, Michael S., Fockele, Callan E, Saheed, Mustapha, Freiermuth, Caroline, Punches, Brittany E., Guo, Clara, Martel, Shara, Owens, Patricia H., Coupet, Edouard, Hawk, Kathryn F.
• Format: Article
• Language: English
• ISSN: 0196-0644; 1097-6760
• DOI: 10.1016/j.annemergmed.2022.05.010

There has been a substantial rise in publications and training opportunities on the care and treatment of Emergency Department patients with opioid use disorder over the past several years. The American College of Emergency Physicians recently published recommendations on providing buprenorphine to patients with OUD, but barriers to implementing this clinical practice remain. We describe the models for implementing ED-initiated buprenorphine at four diverse urban, academic medical centers across the country as part of a federally funded effort termed ‘ Project ED Health’ . These four sites successfully implemented unique ED-initiated buprenorphine programs as part of a comparison of Implementation Facilitation to traditional educational dissemination on uptake of ED-initiated buprenorphine. Each site describes elements central to the ED process including screening, treatment initiation, referral and follow- up while harnessing organizational characteristics including ED culture. Finally, we discuss common facilitators to program success, including information technology and electronic medical record integration, hospital-level support, strong connection to outpatient partners and quality improvement processes.