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Learning about Opioid Use Disorder (LOUD) in the Emergency Department (ED) Resources

Date: March 19, 2020
Filed under: Clinical Care, Substance Use, LOUD in the ED,

Learning about Opioid Use Disorder (LOUD) in the Emergency Department (ED) was a provincial quality improvement initiative focused on ED care for people who use opioids. Check out some of the informative resources below to guide you and your team on your improvement journey!

Getting Started

This resources page is full of links, documents and online training to support your quality improvement journey to improve OUD care in the ED. In consultation with the LOUD in the ED Faculty, four main drivers for improvement were identified and each Action Period focuses on one of those drivers. Read the full LOUD in the ED driver diagram or click on any Action Periods below to see all related recordings and resources.

Action Periods

Action Period 1: Recommended Clinical Decision Support Tools

Implementing recommended practices to inform order sets and guideline development. There is a wide variety of emerging research around buprenorphine-naloxone starts in the ED. We have included a collection of identified resources, Pre Printed Orders (PPOs) and guidelines by our provincial expert faculty to help guide you in making informed decisions for people with OUD presenting at your ED.

Action Period 1 Resources

Action Period 2: Clinical Education and Strategies

Current trainings, culture change and opportunities. Some of the evolving and growing variety of formal training opportunities for clinicians around OUD guidelines.

Action Period 2 Resources

Action Period 3: People- and Provider-Centred Care

Stigma, engagement and access. People with OUD’s long-term relationship with the health care system, as well as their experiences accessing care and treatment, is often dictated by the nature of their first experience with the ED. Having a better understanding of trauma-informed practice, early identification and better clinical understanding of what OUD care looks like can help enhance this experience to be a more positive one – both for people presenting in the ED and for providers. This section of our resource list also includes a link to EQUIP, a series of free online modules around trauma- and violence informed practices, and culturally appropriate care.

Action Period 3 Resources

Action Period 4: Connection Continuum

Bridging community and ED care. Helping people with OUD get connected with the resources they need in the community is an important part of care. These connections are sometimes tricky to navigate, but ultimately can help with a smooth transition to community supports. Better transitions and awareness of community resources can improve outcomes for people with OUD.

Action Period 4 Resources

Action Period 5: Celebration & Wrap-Up

Watch the final learning session which summarizes and celebrates the progress of this initiative as well as the final coaching call which examines key learnings from Alberta’s health care system.

Action Period 5 Resources

Opioid Use Disorder Care in the Emergency Department Webinars

Co-presented by us and the British Columbia Centre on Substance Use, this series of care-based discussions explored ways to enhance care experiences for the treatment of people with opioid use disorder in the emergency department.

To help support busy emergency department care providers, check out preparatory online material with some of the foundations to providing quality care.

Learning About Opioid Use Disorder in the Emergency Department Final Report 2020/21

This report summarizes the background and intent of LOUD in the ED with key learnings and opportunities offered for future initiatives and for system transformation in OUD care within BC.

Read the Report

Language Matters

Additional Tools & Resources

BCCSU List of Common Acronyms & Glossary *PDF*
A quick guide to common terms for discussing substance use care.

Opioid Agonist Treatment: General Information *PDF*
This handout from the BC Center on Substance Use provides general information on OAT, OAT medications and how OAT programs work in BC. 

Frequently Asked Questions about Opioid Agonist Treatment *PDF*
This handout from the BC Center on Substance Use provides answers to some common questions service operators may have about OAT and accommodating clients taking OAT in supportive recovery settings. 

Roles and Responsibilities: Supporting Clients on OAT *PDF*
This handout on the BC Center on Substance Use summarizes the different roles and responsibilities that service operators, clients, and OAT prescribers/teams have in working together to support clients on OAT in supportive recovery settings. Additional resources are also provided on OAT and opioid use disorder. 

Effective Strategies for Hospitals Responding to the Opioid Crisis *PDF*
Report from the Institute for Healthcare Improvement that outlines system-level strategies that hospitals can implement immediately to address the challenges of preventing, identifying, and treating opioid use disorder. 

ED-Initiated Buprenorphine *Link*
This website by the Yale School of Medicine includes resources such as clinical evidence and strategies for motivating patients. 

Culture Change Toolbox
A collection of tools and interventions for changing culture, each one accompanied by tips on how to apply it.

ATTIC: Activities for Transforming Teams & Igniting Change
ATTIC is a collection of activities that you and your team can use to build teamwork, develop communication skills, enable creative thinking and innovation, and help explore systems.

A Guide to Patient Engagement
This BCPSQC resource covers the essentials of patient engagement, how to prepare for it, where you can find patient partners and how to engage them. 

Substance Use & COVID-19 Resources Check out this collection of resources for people who use drugs, providers and more collated by the BC Centre on Substance Use.

Risk Mitigation in the Context of Dual Public Health Emergencies This protocol is intended to provide clinical guidance to health care providers to support patients in the context of the COVID-19 pandemic and overdose crisis.

Ted Talk: Is Safe Supply a Viable Option for the Overdose Crisis? Guy Felicella advocates for harm reduction on behalf of British Columbia’s Overdose Emergency Response Centre, Vancouver Coastal Health’s Regional Addiction Team and the British Columbia Centre on Substance Use. He is also a LOUD in the ED Faculty member.

New Plan G Bridge Coverage & Applications

Plan G Bridge Coverage is now available to provide patients with faster, temporary Plan G coverage. Practitioners in emergency departments (EDs), Rapid Access Addiction Clinics (RAACs), urgent primary care centres (UPCCs), and correctional centres (both provincial and federal) can apply for Plan G bridge coverage, using a new section of the Plan G form. Practitioners can then send the form directly to Health Insurance BC instead of a mental health and substance use centre.

Plan G bridge coverage is provided to patients for 3 months, during which, to continue coverage, patients are to see a practitioner in their community to apply for regular Plan G coverage. This new process should provide patients who need immediate Plan G coverage with the coverage they need, and enough time to connect with a prescriber in the community to apply for regular Plan G coverage.

  • The new Plan G Application Form (to be used for regular, exceptional, and bridge Plan G coverage) is now available
    Download Now
  • A guide to Applying for Plan G Bridge Coverage to help explain the bridge coverage application process is available here.
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