Using quality improvement approaches to increase emergency department provider engagement in research participant enrollment during COVID-19 and opioid overdose public health emergencies

Using quality improvement approaches to increase emergency department provider engagement in research participant enrollment during COVID-19 and opioid overdose public health emergencies

We utilized quality improvement (QI) approaches to increase emergency department (ED) provider engagement with research participant enrollment during the opioid crisis and coronavirus disease (COVID-19) pandemic. The context of this work is the Evaluating Microdosing in the Emergency Department (EME...

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Bibliographic Details
Published in:Canadian journal of emergency medicine Vol. 26; no. 5; p. 349
Main Authors: Hussey, Alisha, Pozsgay, Kaela, Crawford, Carolyn M L, Wang, Yueqiao Elle, Lau, Anthony, Kestler, Andrew, Moe, Jessica
Format: Journal Article
Language:English
Published: England 01-05-2024
Subjects:
Buprenorphine - therapeutic use
COVID-19 - epidemiology
Emergency Service, Hospital
Female
Humans
Male
Naloxone - administration & dosage
Naloxone - therapeutic use
Narcotic Antagonists - administration & dosage
Narcotic Antagonists - therapeutic use
Opiate Overdose - epidemiology
Pandemics
Patient Selection
Public Health
Quality Improvement
SARS-CoV-2
Healthcare research
COVID-19 pandemic
Quality improvement
Opioid crisis
Emergency medicine
Stakeholder engagement
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Summary:We utilized quality improvement (QI) approaches to increase emergency department (ED) provider engagement with research participant enrollment during the opioid crisis and coronavirus disease (COVID-19) pandemic. The context of this work is the Evaluating Microdosing in the Emergency Department (EMED) study, a randomized trial offering buprenorphine/naloxone to ED patients through randomization to standard or microdosing induction. Engaging providers is crucial for participant recruitment to our study. Anticipating challenges sustaining long-term engagement after a 63% decline in provider referrals four months into enrollments, we applied Plan-Do-Study-Act (PDSA) cycles to develop and implement an engagement strategy to increase and sustain provider engagement by 50% from baseline within 9 months. Our engagement strategy was centered on Coffee Carts rounds: 5-min study-related educational presentations for providers on shift; and a secondary initiative, a Suboxone Champions program, to engage interested providers as study-related peer educators. We used provider referrals to our team as a proxy for study engagement and report the percent change in mean weekly referrals across two PDSA cycles relative to our established referral baseline. A QI approach afforded real-time review of interventions based on research and provider priorities, increasing engagement via mean weekly provider referrals by 14.5% and 49% across two PDSA cycles relative to baseline, respectively. Our Coffee Carts and Suboxone Champions program are efficient, low-barrier, educational initiatives to convey study-related information to providers. This work supported our efforts to maximally engage providers, minimize burden, and provide life-saving buprenorphine/naloxone to patients at risk of fatal overdose.
ISSN:1481-8043
DOI:10.1007/s43678-024-00691-7