Placerville

This research aims to assess the impact of a bundle of strategies designed to improve coordination between emergency departments EDs and outpatient clinics for adults starting buprenorphine treatment for opioid use disorder. The study will focus on how these strategies influence long-term retention in buprenorphine treatment after patients leave the ED, measuring outcomes such as days with active buprenorphine prescriptions and timely prescription fills. The study involves multiple hospital EDs and outpatient clinics and addresses the challenge of maintaining effective treatment following initial ED care. Participants will experience a stepped implementation across 12 sites, where each site adopts the care coordination strategies at different times over a 12-month period. Before implementation, standard referral and coordination procedures are used after implementation, ED and outpatient teams incorporate the new strategies, which include standardized notes, improved information sharing, enhanced patient contact methods, clearer team roles, procedures for same-day refills, and external facilitation. These strategies are tailored to each sites needs. During the study, participant data will be collected from electronic health records and linked prescription monitoring programs to track buprenorphine treatment continuity and retention at 3, 6, and 12 months after the initial ED visit. Clinician surveys will evaluate changes in care coordination quality. The studys primary outcome focuses on continuous buprenorphine treatment at 6 months, with secondary outcomes at other time points. Results aim to guide broader implementation to improve opioid use disorder treatment outcomes nationwide.