SHM Converge Scientific Abstract ePoster Gallery-Interdisciplinary Collaboration to Improve Inpatient Treatment of Opioid Use Disorder

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This document describes a Mayo Clinic quality-improvement initiative to improve inpatient treatment of opioid use disorder (OUD) and opioid withdrawal (OW) through interdisciplinary collaboration. The project was led by physicians, advanced practice providers, nursing, pharmacy, and social work teams across Mayo Clinic sites in Rochester and Arizona.<br /><br />The need for the initiative was based on several barriers: buprenorphine was being underused for OW and OUD, with only 6.9% of eligible patients receiving it. Other challenges included uncertainty about who should manage addiction care in the hospital, prescribing limitations and lack of training, unclear referral pathways for ongoing treatment, stigma and bias, and competing clinical demands.<br /><br />The effort was informed by the Society of Hospital Medicine consensus statement, which recommends that hospitalized patients with unhealthy opioid use be assessed for OUD, that buprenorphine or methadone be offered as first-line treatment for OW and OUD, that buprenorphine be prescribed at discharge, and that patients be linked to an outpatient buprenorphine prescriber.<br /><br />Interventions included protected training time for physicians and APPs, a centralized list of experienced prescribers for curbside consultation, inpatient buprenorphine initiation and OW order sets, and collaboration with outpatient MOUD clinics. Nursing interventions included appointing a Clinical Nurse Specialist as project manager, standardizing COWS education for bedside nurses, and adding screening tools on admission. Pharmacy developed educational modules, a pharmacy consult within the buprenorphine order set, and an electronic health record smartphrase. Social work expanded access to substance use consultation, outpatient resources, formal assessments, and financial assistance.<br /><br />Overall, the project aimed to create a coordinated system that improves access to lifesaving buprenorphine treatment and better supports hospitalized patients with OUD.

Asset Subtitle

Gretchen A. Colbenson

Meta Tag

Author List Christine Aliory, Gretchen A. Colbenson, Julie Cunningham, Mary Beth Chambers, Nathan Smith, Robert W. Kirchoff

Category Innovations

Concept Opioid Use Disorder

Concept Multidisciplinary Collaboration

Concept Buprenorphine

Concept Hospital Buprenorphine Initiation

Concept Inpatient Treatment

Distinguished Non-Finalist

Presenter Organization Mayo Clinic

Presenting Author Gretchen A. Colbenson

Track Quality Improvement

Keywords

opioid use disorder

opioid withdrawal

buprenorphine

inpatient treatment

quality improvement

interdisciplinary collaboration

Mayo Clinic

MOUD

hospital medicine

substance use consultation

Opioid Use Disorder

Multidisciplinary Collaboration

Buprenorphine

Hospital Buprenorphine Initiation

Inpatient Treatment