TY - JOUR
KW - Canada
KW - Community Health Centers/organization & administration
KW - Health Plan Implementation/organization & administration
KW - Health Services Research
KW - Humans
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/rehabilitation
KW - Patient Care Team
KW - Quality Improvement/organization & administration
KW - buprenorphine/naloxone
KW - Mental Health
KW - Methadone
KW - opioid agonist therapy
KW - opioid use disorder
KW - primary care
KW - Quality Improvement
KW - Retention
KW - Suboxone
KW - Substance use disorder
AU - L. Beamish
AU - Z. Sagorin
AU - C. Stanley
AU - K. English
AU - R. Garelnabi
AU - D. Cousineau
AU - R. Barrios
AU - J. Klimas
A1 - 
AB - BACKGROUND: Although opioid agonist therapy is effective in treating opioid use disorders (OUD), retention in opioid agonist therapy is suboptimal, in part, due to quality of care issues. Therefore, we sought to describe the planning and implementation of a quality improvement initiative aimed at closing gaps in care for people living with OUD through changes to workflow and care processes in Vancouver, Canada. METHODS: The Best-practice in Oral Opioid agoniSt Therapy (BOOST) Collaborative followed the Institute for Healthcare Improvement's Breakthrough Series Collaborative methodology over 18-months. Teams participated in a series of activities and events to support implementing, measuring, and sharing best practices in OAT and OUD care. Teams were assigned monthly implementation scores to monitor their progress on meeting Collaborative aims and implementing changes. RESULTS: Seventeen health care teams from a range of health care practices caring for a total of 4301 patients with a documented diagnosis of OUD, or suspected OUD based on electronic medical record chart data participated in the Collaborative. Teams followed the Breakthrough Series Collaborative methodology closely and reported monthly on a series of standardized process and outcome indicators. The majority of (59%) teams showed some improvement throughout the Collaborative as indicated by implementation scores. CONCLUSIONS: Descriptive data from the evaluation of this initiative illustrates its success. It provides further evidence to support the implementation of quality improvement interventions to close gaps in OUD care processes and treatment outcomes for people living with OUD. This system-level approach has been spread across British Columbia and could be used by other jurisdictions facing similar overdose crises.
AD - British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; Vancouver Coastal Health, 520 W 6th Ave, Vancouver, BC, V5Z4H5, Canada.; St. Paul's Hospital, Providence Health Care, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; Vancouver Coastal Health, 520 W 6th Ave, Vancouver, BC, V5Z4H5, Canada.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada. rbarrios@cfenet.ubc.ca.; Vancouver Coastal Health, 520 W 6th Ave, Vancouver, BC, V5Z4H5, Canada. rbarrios@cfenet.ubc.ca.; Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T1Z3, Canada. rbarrios@cfenet.ubc.ca.; British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; British Columbia Centre on Substance Use, 400-1045 Howe St, Vancouver, BC, V6Z2A9, Canada.; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z1Y6, Canada.; School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
BT - BMC health services research
C5 - Education & Workforce; Opioids & Substance Use
CP - 1
DO - 10.1186/s12913-019-4472-8
IS - 1
JF - BMC health services research
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Although opioid agonist therapy is effective in treating opioid use disorders (OUD), retention in opioid agonist therapy is suboptimal, in part, due to quality of care issues. Therefore, we sought to describe the planning and implementation of a quality improvement initiative aimed at closing gaps in care for people living with OUD through changes to workflow and care processes in Vancouver, Canada. METHODS: The Best-practice in Oral Opioid agoniSt Therapy (BOOST) Collaborative followed the Institute for Healthcare Improvement's Breakthrough Series Collaborative methodology over 18-months. Teams participated in a series of activities and events to support implementing, measuring, and sharing best practices in OAT and OUD care. Teams were assigned monthly implementation scores to monitor their progress on meeting Collaborative aims and implementing changes. RESULTS: Seventeen health care teams from a range of health care practices caring for a total of 4301 patients with a documented diagnosis of OUD, or suspected OUD based on electronic medical record chart data participated in the Collaborative. Teams followed the Breakthrough Series Collaborative methodology closely and reported monthly on a series of standardized process and outcome indicators. The majority of (59%) teams showed some improvement throughout the Collaborative as indicated by implementation scores. CONCLUSIONS: Descriptive data from the evaluation of this initiative illustrates its success. It provides further evidence to support the implementation of quality improvement interventions to close gaps in OUD care processes and treatment outcomes for people living with OUD. This system-level approach has been spread across British Columbia and could be used by other jurisdictions facing similar overdose crises.
PY - 2019
SN - 1472-6963; 1472-6963
SP - 019
EP - 8
EP - 663+
T1 - Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting
T2 - BMC health services research
TI - Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting
U1 - Education & Workforce; Opioids & Substance Use
U2 - 31521159
U3 - 10.1186/s12913-019-4472-8
VL - 19
VO - 1472-6963; 1472-6963
Y1 - 2019
Y2 - Sep 14
ER -