LOUD in the ED is a provincial initiative led by the BC Patient Safety & Quality Council in partnership with the Overdose Emergency Response Center and the BC Centre on Substance Use. Twenty-five teams will participate in a virtual action series from October 2020 to February 2021. During the initiative teams can expect the following:

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:

• Five learning webinars held in the first week of each month (October 2020 – February 2021)
• Action periods between webinars during which teams will work together to improve their OUD care
• Action period guides with a toolkit of change ideas, activities and resources to guide your improvement journey
• Ongoing coaching and support to individual teams and larger groups
• Tools and resources to help teams develop a better understanding of OUD care and plan their quality improvement;
• A network of 24 other teams across the province for inspiration and support;
• Optional randomized coffee trials with others in the initiative to create informal ties and strengthen the network;
• A certificate of completion; and
• A copy of the final report for the initiative.

This action series will combine opportunities for learning and networking with opportunities to apply change ideas at local sites. This will look like:

• Five interactive webinars to teach and highlight tools for improving care in your ED;
• Action periods following each webinar during which your team works together to explore application of the new tools and translate ideas into practice;
• Coaching calls to support your team in your improvement efforts.

A measurement plan provided to teams 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 resources and education. 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.

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.

Webinars will be scheduled and delivered using Zoom. This technology has both video conferencing and call-in options. Webinars will be recorded and posted online for anyone not able to attend in real time. Specific information on the webinar and login instructions will be shared well in advance of the event.

There is no charge to participate. 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 backfill for three team members (including up to one physician) to attend the learning webinars; 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);and
• Executing action period work, change ideas and tests of change!