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LOUD in the Emergency Department Collaborative

A provincial initiative to improve quality of ED care for people living with opioid use disorder (OUD).

Strengthening OUD care in EDs is critical to saving lives, reducing opioid-related harms and reducing the burden of the toxic drug poisoning public health emergency.

By participating in LOUD in the ED, ED teams can accelerate provincial change in improving OUD care by gaining access to tools, resources and clinical and quality improvement supports for improving OUD care delivery that is timely, effective, safe and patient-directed.

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Did You Know?

Emergency departments are critical places of opportunity for early engagement of substance use care and prevention of toxic drug poisonings.

Approximately 60% of those who experience a toxic drug poisoning have visited the emergency department in the year prior for various health reasons.*

Starting buprenorphine-naloxone in the ED more than doubles the 30-day retention in addictions care relative to referral alone.*

People who leave the ED after a toxic drug poisoning event are over 7 times more likely to die within a year compared to those visiting for other reasons, and studies have shown that nearly 1 in 5 who visit the ED due to opioid-related harms leave without completing their care.*

LOUD in the ED Collaborative Overview

LOUD in the ED is led by Health Quality BC in partnership with Emergency Care BC and the BC Centre on Substance Use. This work is being done in collaboration with health authorities, with funding and support from the Ministry of Health through the Community Action Initiative.

Focus Areas

ED teams of all sizes engage in activities designed to improve OUD identification, therapeutic intervention and connection to follow-up, with the overall aim of reducing the number of deaths due to BC’s ongoing toxic drug crisis.

  • Improving processes using updated Decision Support Tools
  • Embedding employed Peer Support Workers (PSWs)
  • Education dissemination
  • Innovation in care transitions processes

Participants take action alongside their peers by connecting with clinical and quality improvement experts and accessing tools and resources that have been co-developed with practitioners, people with lived/living experience and leaders in the health system. This includes Implementation Supports for the Integrated Interdisciplinary Model of Opioid Agonist Treatment (IIMOAT), Peer Support Toolkits, Decision Support Tools for OUD Care Support, a Guide to Measuring Change and more.

Expectations of Participation

To engage in the program, participating ED teams are expected to:

  • Work with an ED team to make improvements
  • Complete ED readiness activities between now and April
  • Attend five synchronous sessions between March – November 2025
  • Participate in monthly action period calls
  • Testing and measuring change ideas 

Funding Available to Participate

There is no cost to participate, and no quality improvement experience is necessary.

LOUD in the ED Collaborative TIMELINE

Now – Feb 2025
Team Enrollment
March 4, 2025
Pre-Collaborative Training for Team Leads (Virtual)
April 30, 2025
Learning Session 1 (In-Person, Vancouver)
May 14, 2025
Action Period Call 1 (Virtual)
June 11, 2025
Action Period Call 2 (Virtual)
June 19, 2025
Learning Session 2 (Virtual)
July 9, 2025
Action Period Call 3 (Virtual)
August 13, 2025
Action Period Call 4 (Virtual)
September 10, 2025
Action Period Call 5 (Virtual)
October 7, 2025
Learning Session 3 (Tentative In-Person, Vancouver)
November 12, 2025
Celebrating & Maintaining the Gains (Virtual)

LOUD in the ED Collaborative Frequently Asked Questions

Each team requires at least one Team Leader and 2-7 team members. We encourage teams to recruit a variety of participants and strongly recommend at least one physician, nurse, pharmacist, and a peer support worker. Consider who is interested in this work and is well-positioned to support quality improvement in the emergency department. Some examples include, but are not limited to:

  • Physicians (ED, Addictions)
  • Nurses (ED, Addictions)
  • Peer Workers/PWLLE
  • Pharmacists & Technicians
  • Indigenous Patient Navigators
  • Security Staff
  • Leadership (Operations, Education)
  • Social Workers
  • Unit Clerks & Care Aides
  • Quality & Safety Teams

Executive Sponsorship

Each team will require explicit endorsement for participation from an Executive Sponsor. This individual is typically at the level of Director or Executive Director and can support teams with accelerating change and navigate system barriers at the local ED level.

There is no charge to participate in the collaborative.

Travel costs (flight and accommodation) for up to three people per team will be covered for in-person activities. Funding is available for practitioners who take time away from clinical care to participate in collaborative activities. Compensation is available based on current sessional rates for practitioners’ time (who are not being funded through salary or contract) to attend learning sessions and coaching calls. Time to engage in project work outside of official collaborative calls and sessions will not be compensated through HQBC.

Have a question that’s not answered here? Reach out to us at loud@healthqualitybc.ca.

Ready to Improve OUD Care in Your ED?

Action starts here. Enhance OUD care and make a difference in your ED.

Register Now