In February 2018, Island Health emergency physician Dr Jason Wale presented his Physician Quality Improvement project on opioid substitution therapy at Quality Forum 2018.
Quality Forum, put together by the BC Patient Safety and Quality Council, is an annual conference to discuss how to improve health-care quality and patient safety. Dr Wale presented his project, Opioid Substitution Therapy: An Emergency Room Response to the Fentanyl Crisis, in the Champions of Change section and during the main forum.
Working in the RJH and VGH emergency departments, Dr Wale recognized the need to shift the emergency department culture to try and prevent overdose deaths. The Physician Quality Improvement initiative provided the opportunity to start.
The Physician Quality Improvement initiative is the result of collaboration between Doctors of BC, the Ministry of Health and Island Health. Physicians with quality improvement ideas apply to the program and accepted applications receive one-year of support. This includes quality improvement curriculum delivered in a cohort workshop environment and support from a dedicated team to help their quality improvement project.
Dr Wale and his team focused on improving access to the opioid substitution therapy Suboxone for emergency department patients with opioid addiction. The team worked with the Victoria Rapid Addiction Access Clinic, Youth Clinic and Cool Aid Clinics to standardize emergency department rapid referral protocols at both the Victoria General and Royal Jubilee emergency departments. Using rapid referral protocols, early peer support of the Umbrella Society and emergency physician initiated Suboxone therapy when appropriate, the goal is to offer all opioid addicted patients presenting in emergency departments the opportunity to proactively address their addictions.
Results from the project show that emergency department physicians and nurses are now starting to feel more comfortable administering opioid substitution therapies and referrals to various community providers are increasing.
Physicians interested in PQI should contact PQI manager, Carolyn Carlson (Carolyn.Carlson@islandhealth.ca 250-668-4876) for more information. Physicians are always encouraged to reach out about potential projects.