Substance Use

Loud in the ED

Frequently Asked Questions

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Frequently Asked Questions

LOUD in the ED has been postponed.

LOUD in the ED

LOUD in the ED stands for Learning about Opioid Use Disorder in the Emergency Department. The name was chosen to encourage discussion and awareness about opioid use disorder (OUD) and to impact the quality and accessibility of OUD services in local emergency departments (EDs).

LOUD in the ED is a provincial collaborative led by the BC Patient Safety & Quality Council in partnership with the Overdose Emergency Response Center and the BC Centre on Substance Use. It is based on the Institute for Healthcare Improvement’s Breakthrough Series Collaborative model for health care improvement.

Up to 22 teams will be invited to six virtual learning webinars and one in-person learning day in Vancouver. Teams will be provided with a robust toolkit (a Change Package) full of change ideas and quality improvement methodologies to guide improvement at the point of care. The teams will have access to a faculty of subject area experts from across the province, coaching calls and site visits from key leaders to help with their improvement efforts.

LOUD in the ED aims to improve the experience of OUD care for people and providers, and to reduce the morbidity and mortality for people with OUD in the ED by improving access to evidence-informed care. This includes access to buprenorphine-naloxone (Suboxone®).

Twenty-one percent of people with OUD have their first point of contact with the health care system in the ED – there is never a second chance to make a first impression. The ED setting provides a unique opportunity to connect with people who use drugs and intervene early. Your ED team is likely already experiencing the effects of OUD on a daily basis and this initiative will support you to provide evidence-based, quality care.

Applying best practice for people with OUD in the ED improves patient care and has the potential to reduce length of stay, readmission rates, and workload and burnout for staff.

Your team will benefit from focused support, the opportunity to collaborate with, and learn from, other teams from across the province, and quality improvement training that can be applied to all areas of care you provide.

Participating teams will be provided with the following resources and supports:

  • A Change Package to help teams develop a better understanding of OUD care and plan their quality improvement;
  • A network of 21 other teams across the province for inspiration and support;
  • A series of interactive webinars grounded in evidence and led by expert faculty;
  • A one-day in-person learning session in Vancouver to connect with other teams across BC;
  • Virtual coaching and support;
  • An in-person site visit;
  • A certificate of completion; and
  • A copy of the final report for the collaborative.


A collaborative is a specific model for quality improvement. It emphasizes peer-to-peer learning, standardized measurement and education, an “all teach, all learn” focus for webinars and coaching calls, and being responsive to local context. Participating teams form a network and work on similar challenges while maintaining flexibility to approach issues specific to their community.

There is incredible work already happening across the province that is unique and adapted to local contexts and communities. The collaborative model is an effective and efficient way to leverage that work by offering a platform for teams to connect and learn from each other as well as a faculty of experts to support them. By developing a toolkit of methodologies and measurement strategies, team efforts and accomplishments will help inform next steps, policy development, resource creation and practice change for OUD care in the ED.

A measurement plan will be included in the Change Package with suggested measures for teams to track their improvement efforts and impacts.

PWLLE are integral members and leaders in both the planning and action stages of the collaborative. Some of the faculty members are PWLLE, and additional PWLLE are being engaged in the development of the Getting Started Kit. Participating teams are encouraged to have a PWLLE as part of their core team membership. More information on how to recruit and support PWLLE on your team will be provided in the coming weeks.


Look for our Call to Action posters in the staff room at your ED to sign up! Local team coordinators will work with Regional Response Team leads/designates to identify interested individuals who will form their local team. Reach out to your local ED manager or Clinical Nurse Educator to see if they are coordinating a team or contact your Regional Response Team lead/designate to see if your site has been identified for the collaborative. If you are not sure who your local team coordinator or Regional Response Team lead is, please contact us.

Regional Response Team leads/designates in each health authority have been tasked with identifying sites with the most need and interest in participating. The focus is on a distribution of sites across each health authority and a mix of rural, mid-sized and urban sites. If spots are still available after this targeted approach, health authorities and the collaborative project team will work together to identify additional teams and fill remaining spots.

If your site is not currently involved in the collaborative, you are still welcome to contact us to sign up for our newsletter, where you’ll receive updates and access to all our resources and webinars once they have been posted to the website.

Anyone who is interested in improving OUD care in the ED! This may include physicians, nurses, unit clerks, social workers, physiotherapists, pharmacists, peers, families, community workers and others.

Your team should aim to recruit four to seven people from different disciplines, including clinicians who work in or alongside the ED. We strongly encourage at least one physician and one nurse on each team, and you may consider augmenting your team from time to time with ad-hoc members as needed. Additional team members could include pharmacists, clerks, emergency medical services (EMS) personnel, respiratory therapists – the makeup of your team is up to you!

Yes, you can still participate! Webinars will be recorded and made available to view. Coaching and site visits will be scheduled to work with the local team to allow as many team members to attend as possible. The learning and testing of change ideas can happen on a flexible schedule that works for your team.

All of the content and learning generated from this collaborative will be accessible online as the collaborative progresses. Watch for updates with the web address in the near future!

This project is focused on learning and improving OUD care in the ED. This means that some teams will be supported in initiating the use of buprenorphine-naloxone (Suboxone®) in the ED, while other teams will be working on improving their already existing buprenorphine-naloxone (Suboxone®) care.


Sites participating in LOUD in the ED will form interdisciplinary teams. These teams will identify goals and strategies specific to improving OUD care in their local ED, including developing connections to the community. Teams will support practice change, measure and evaluate their success and share their experience with others across the province. Teams will be expected to provide regular reporting as a condition of participating, but measurements will be kept as simple as possible to avoid extra burden

Participating teams will be asked to complete pre-work before the collaborative launch and share information and data following the completion of the collaborative.

Team members should plan to:

  • Engage in team meetings and project work at their site;
  • Attend the April 22, 2020 full-day in-person session in Vancouver to connect with other teams and exchange ideas;

Participate in a one-hour webinars every two to three weeks (note that all webinars will be recorded to facilitate easy referencing and various shift schedules).

Yes, you can still participate in the collaborative! The in-person day is a great opportunity for teams to build relationships, share change ideas, learn from each other and strengthen team collaboration through cooperative learning. There should be representation from your team at the in-person learning day in Vancouver. However, it is not a mandatory requirement for all individuals on the team to participate. The collaborative will offer multiple opportunities to connect virtually, as well as to work deeply with team members at your local site.

Webinars will be scheduled and delivered using WebEx, which can be accessed at on the day of the event. This technology has both video conferencing and call-in options. Webinars will be recorded and posted online for anyone not able to attend in person. Specific information on the webinar and login instructions will be shared well in advance of the event.

There is no charge to participate in the collaborative. The improvement work involved in this collaborative will be supported by your manager and embedded into your everyday workload. Some funding is available through the Community Overdose Crisis Innovation Fund provided by the Ministry of Mental Health and Addictions. Funding is available for:

  • Costs associated with travel and backfill for three team members (including up to one physician) to attend the in-person session; and
  • Support for physician leadership.

Individual team members will contribute the time required to participate in the collaborative including:

  • Engaging in team meetings and communication;
  • Participating in online webinars (or recordings);
  • Potentially attending the in-person learning day (as determined by your team); and
  • Executing change ideas and tests of change!

Contact Us

Please contact the LOUD in the ED project team at

Key Contact

Kate Harris
Leader, Health System Improvement