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LOUD in the Emergency Department
(LOUD in the ED) Collaborative

A provincial quality improvement initiative focused on improving quality of ED care for people living with opioid use disorder (OUD).

Running until summer 2025 the LOUD in the ED Collaborative is a unique opportunity to work with partners across the province with the aim of improving ED care for those living with OUD. Whether you are in a regional or site-specific role, you can join this provincial initiative to support system-wide and sustainable changes that meet the care goals of those receiving and delivering OUD care in ED settings.

Express Your Interest Learn More

Improve OUD Care Across the Province

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 Mental Health & Addictions and Ministry of Health through the Community Action Initiative.

By joining LOUD in the ED, you can take part in the co-development and spread of effective tools and practices to improve OUD care in EDs across the province.

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Convene & Co-develop

Project Goals and Deliverables

Connect & Take Action
with Colleagues

In-Person and virtually

Implement & Spread

Resources, Tools and Best Practices with Teams

Where Do You See Yourself Making a Difference?

How do we improve OUD care in emergency departments around the province? We reached out to key partners across the health care system to identify opportunities to better support care.

This is what we heard:

  • OAT Access for All: OAT is a best-practice treatment, but access to it is inconsistent across the province.
  • Team Growth with Peer Support Workers: Care is less effective when substance use needs are poorly discussed, and is increasingly inaccessible for those who are leaving the ED without being seen.
  • Efficient & Effective Learning: Navigating the vast amount of substance use education for clinicians can be overwhelming or challenging to translate into practice.
  • ‘Warm Handoff’ Care Transitions: Continuity of care gaps when moving in and out of EDs pose a safety risk for patients.

System-wide Action is Needed

All roles involved in OUD care for EDs are encouraged to join LOUD in the ED! Whether you’re an individual or a team in regional leadership or point of care in hospitals and community, we want to hear from you! Involvement from across the system is needed to make a difference.

Express Your Interest Read Our Frequently Asked Questions (FAQs)

LOUD in the ED Collaborative Frequently Asked Questions

The Learning about Opioid Use Disorder in the Emergency Department (LOUD in the ED) Collaborative is a provincial quality improvement initiative focused on improving quality of care for people with OUD in EDs. The aim of this improvement collaborative is to elevate the quality of care for people with OUD by increasing access to OAT and reducing preventable harms from emergency department care. This work will be done in collaboration with health authorities in four workstreams:

  • OAT Access for All
  • Team Growth with Peers
  • Efficient and Effective Learning
  • Warm Hand-Off Care Transitions

The collaborative is currently in progress and will be running until June 2025. It is building off of the first iteration, the LOUD in the ED action series, delivered in 2020/21. This collaborative is led by Health Quality BC (HQBC) in partnership with Emergency Care BC and the BC Centre on Substance Use, with funding and support from the Ministry of Mental Health & Addictions and Ministry of Health through the Community Action Initiative.

Participants can join one or more workstreams:

  1. OAT Access for All: While Opioid agonist therapy (OAT) is a best practice treatment for OUD, there are still barriers to accessing appropriate and timely care in Emergency Departments across the province. In this workstream, you can support the development of an assessment tool for OAT services to allow health authorities to identify opportunities for improvement. This work will also identify innovative and emerging OUD care practices for spread and implementation.
  2. Team Growth with Peer Support Workers: Care is less effective when substance use needs are poorly discussed, and is increasingly inaccessible for those who are leaving without being seen. To improve ED capacity, employed peers in care teams can foster safer welcomes, appropriate conversations, and connections to on-site services, such as overdose prevention sites. In this workstream, you can support health authorities to implement high-quality models for employed peers in EDs, through co-development of an implementation toolkit.
  3. Efficient & Effective Learning: Navigating the vast amount of substance use education for clinicians can be overwhelming or challenging to translate into practice. In this workstream, you can support assessing the evaluation of the impacts of education training across health authorities. Innovative and effective models will be consolidated and spread through the collaborative to improve consistency.
  4. ‘Warm Handoff’ Care Transitions: Continuity of care gaps when moving in and out of EDs pose a safety risk for patients. LOUD in the ED can support targeted community-ED relationship building which creates a shared mindset for decision-making that results in effective referrals and transitions.

Throughout the collaborative, we will be embedding measurement and evaluation within each workstream. This will accelerate short-term improvements, help sustain the gains and inform a broader provincial OUD measurement framework.

LOUD in the ED is an opportunity to connect, collaborate and take action with colleagues across the province. Most of the collaborative will be executed remotely, including some synchronous and asynchronous work, with site visits as required by the Health Quality BC team.

LOUD in the ED was designed with consideration of capacity challenges and diverse roles participating across the system. We are working on a phased approach where participant involvement can vary according to phase and workstream, and will be discussed in further detail as we gather expressions of interest. Everyone who submits an expression of interest form will receive a one-to-one call to explore what their participation can look like. Participation in the collaborative may involve:

  • Engaging through one-to-one meetings or group brainstorming sessions to share your experience and knowledge;
  • Being part of a working group that co-develops new tools or processes that will be spread to emergency departments across BC;
  • Joining an action team that will help implement quality improvement changes in your ED.

Once workstream recruitment is complete, participants will be involved in one or both phases as outlined below. Please note that timelines may be subject to change.

Phase 1. Convene and Co-develop (Now through Winter 2025)

In this phase, we are looking for health authority leaders in emergency care, substance use care, and quality improvement, as well as clinical experts and point of care practitioners to be involved in the convene and co-develop phase of all workstreams. You can choose to be involved in multiple workstreams if interested.

This phase will consist of convening interested parties and building co-development focus groups for each workstream. This will involve regular work workstream meetings (frequency and duration as agreed upon) to co-develop resources/tools and advise on implementation strategies.

In-Person Gathering (Date TBD – 2025)

In November, we are planning an all-day in-person gathering in Vancouver, BC. Funding and space is limited to support attendance, and further details will be shared soon. This event will focus on:

  • Connection and learning with colleagues across the province
  • General education about the collaborative and Quality Improvement basics
  • Workstream deliverables that would benefit from in-person collaboration (e.g. Planning for Plan-Do-Study-Act (PDSA) cycles, measurement strategies, and communications)
  • Education and spread of specific workstream deliverables among implementation teams

Phase 2. Implement and Spread (Winter – Summer 2025)

In this phase, we are looking for emergency department teams and quality improvement leaders who are keen to be involved in improving OUD care on a site-specific level. Similar to phase 1, teams can focus on one workstream or multiple, depending on capacity and priorities in their emergency department.

This phase will consist of convening site-specific teams to engage in quality improvement work, including:

  • Partnering with implementation leads from the Ministry of Health and Health Authorities
  • Coaching ED teams with potential spread-sprints or action series

No matter which workstream and phase you engage in, you will be supported through collaboration, coaching, peer-to-peer learning and embedded measurement. Funding is available to participate.

Anyone who is interested in improving OUD care in emergency departments can participate! We need a variety of system partners to engage in both phases to see real impact on the system.

The collaborative is designed for all roles involved in care, including but not limited to:

  • Point of care professions: paramedics, ED physicians, nursing, care aides, harm reduction, pharmacists, specialists
  • Administration: unit clerks, data entry clerks, researchers
  • Allied health and community supports: Indigenous patient navigators/liaisons, social workers, patient care coordinators, counsellors, peers, patient partners
  • Regional/system: leadership, management, operations, quality improvement, policy

Space is limited so express your interest today! We look forward to speaking with you about whether LOUD in the ED is a good fit for you and/or your team.

There is no charge to participate in the collaborative.

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 workstream meetings or events will not be compensated through HQBC.

There is incredible work already happening across the province that is unique and adapted to local contexts and communities. Working collaboratively is an effective and efficient way to leverage that work by offering a platform for teams to connect and learn from each other, co-design and co-develop a potential solution, with clinical and quality improvement experts to support them. By developing a toolkit of methodologies and measurement strategies, team efforts and accomplishments can help inform next steps, resource creation and practice change for OUD care in EDs.

LOUD in the ED will emphasize peer-to-peer learning, standardized measurement and education, with a focus on “all teach, all learn”. Participants work on similar challenges while maintaining flexibility to approach issues specific to their community/region.

Express Your Interest Today

Start your LOUD in the ED Collaborative journey by expressing your interest. If you still have questions please get in touch at loud@healthqualitybc.ca.

Express Your Interest