• Lauren K Whiteside, Gail D'Onofrio, David A Fiellin, E Jennifer Edelman, Lynne Richardson, Patrick O'Connor, Richard E Rothman, Ethan Cowan, Michael S Lyons, Callan E Fockele, Mustapha Saheed, Caroline Freiermuth, Brittany E Punches, Clara Guo, Shara Martel, Patricia H Owens, Edouard Coupet, and Kathryn F Hawk.
• Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA. Electronic address: laurenkw@uw.edu.
• Ann Emerg Med. 2022 Nov 1; 80 (5): 410419410-419.

AbstractThere has been a substantial rise in the number of publications and training opportunities on the care and treatment of emergency department (ED) patients with opioid use disorder over the past several years. The American College of Emergency Physicians recently published recommendations for providing buprenorphine to patients with opioid use disorder, but barriers to implementing this clinical practice remain. We describe the models for implementing ED-initiated buprenorphine at 4 diverse urban, academic medical centers across the country as part of a federally funded effort termed "Project ED Health." These 4 sites successfully implemented unique ED-initiated buprenorphine programs as part of a comparison of implementation facilitation to traditional educational dissemination on the uptake of ED-initiated buprenorphine. Each site describes the 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 connections with outpatient partners, and quality improvement processes.Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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