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A Dose of Change: Advancing Buprenorphine Induction Practices in the ED
Friday April 25, 2025 10:40am - 10:55am EDT
Athena C
Title: A Dose of Change: Advancing Buprenorphine Induction Practices in the ED
Authors: Samantha Keen, Rebecca Maloney
Objective:  Final pending
Self Assessment Question: Final pending
Background: 
Opioid use disorder (OUD) continues to be one of the most pressing public health crises in the United States, claiming thousands of lives each year through overdose and contributing to a wide range of social, health, and economic burdens. Emergency departments (EDs) often serve as critical initial points of care for veterans in acute opioid-related crises, yet many leave without access to evidence-based treatment. This initiative aims to improve care quality by implementing standardized buprenorphine induction protocols in the ED, focusing on reducing barriers to treatment initiation and facilitating transitions to outpatient care. Despite the strong evidence and growing support for buprenorphine induction in the ED, our facility does not currently offer this service to veterans presenting with OUD. This gap in care is significant, as veterans who come to the ED for issues related to opioid use often leave without being connected to ongoing treatment, leading to continued cycles of misuse and repeated ED visits. Implementing standard buprenorphine induction protocols in the ED would help bridge this gap, providing veterans with immediate access to life-saving treatment and significantly improving their chances of long-term recovery.  By addressing logistical challenges, enhancing care coordination, and fostering staff engagement, the project seeks to improve patient outcomes, reduce ED recidivism, and promote continuity of care for veterans with OUD.
Methods: 
This prospective interventional cohort study will be conducted in the emergency department at the James H Quillen VA Medical Center.  The study will consist of two phases: a baseline period (pre-implementation) and an intervention period (post-implementation).  During the baseline period, data will be collected retrospectively on patients presenting with OUD to the ED and treated with standard care.  During the intervention period, a buprenorphine induction protocol with an order set will be implemented.  Education on appropriate use of the protocol will be provided to the ED mental health providers.  This intervention will be implemented as part of standard of care treatment for this quality improvement project.  Following implementation and education, this intervention will be considered standard of care for management of OUD in the ED.  Data collection for both phases will include the number of patients screened, buprenorphine inductions performed, and rates of successful outpatient referrals.   Following evaluation of the data collected, continuous monitoring of outcomes and quality metrics will occur.   Outcomes measured will be the number of patients who receive a buprenorphine prescription through the ED and referrals the SUD clinic.  
Results: In progress
Conclusions: In progress
Moderators
avatar for Devin Lavender

Devin Lavender

Clinical Assistant Professor, UGAA1University of Georgia College of Pharmacy (Ambulatory Care)PGY2
Ambulatory Care, Scholarship of Teaching and Learning, Resident and Student Development.
Presenters
avatar for Samantha Keen

Samantha Keen

PGY1 Pharmacy Resident, James H Quillen VA Medical Center
Dr. Samantha Keen grew up in in Southwest Virginia where she attended Southwest Virginia Community College and received an Associates of Science degree. She then moved to Johnson City, TN in 2020 to attend East Tennessee State University where she earned a Bachelor of Pharmaceutical... Read More →
Evaluators
CW

Crystal Wright

Pain and Palliative Care Clinical Pharmacy Specialist, Kaiser Permanente Georgia
Friday April 25, 2025 10:40am - 10:55am EDT
Athena C
  Ambulatory Care (AMB), VA - Mountain Home, TN - James H. Quillen VA Medical Center
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