Annals of emergency medicine
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There 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. ⋯ 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.
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We assessed whether the timing and order of patients over emergency shifts are associated with receiving diagnostic imaging in the emergency department and characterized whether changes in imaging are associated with changes in patients returning to the ED. ⋯ Imaging in the ED is associated with shift length and especially patient order, suggesting that physicians make different imaging decisions over the course of their shifts. Additional imaging does not translate into reductions in subsequent bouncebacks to the hospital.