The teams participating in the BC-CfE’s Provincial BOOST Collaborative met in June for its third learning session, and is now approaching the halfway point for the quality improvement project aiming to improve engagement in treatment for opioid use disorder.
The BC-CfE’s Provincial BOOST Collaborative aims to provide quality improvement practices to a network of clinics from across the province. These clinics are providing opioid agonist treatment (OAT) to individuals with substance use disorders. Research shows the risk of morbidity and mortality decreases by 90% for individuals on effective OAT-but retaining individuals in care is very challenging.
BOOST is aiming for big, but attainable, goals: to ensure that 95% of people with opioid use disorder have an active OAT prescription and 95% of those on OAT are retained at three months (or longer).
Made up of 32 participating teams, BOOST includes both health authority and private practice teams from across the province. It aims to work with provincial Health Authorities to help engage and retain more individuals in OAT treatment for opioid use disorder. The Collaborative is applying lessons learned in BC’s response to the HIV epidemic to addressing the ongoing overdose crisis, and is modelled on the STOP HIV/AIDS¨ Collaborative that helped improve access to HIV care and treatment.
The BOOST Collaborative is reaching its halfway point and met for its third Learning Session in June. At the session, teams continued to share best practices and lessons learned so far. In keeping with the spirit of BOOST, simple solutions were offered for pressing issues. The teams discussed small changes they were taking to improve their clients’ access to lifesaving opioid agonist treatment.
For example, Jennifer Block from the VIHA Health Connection said she and her team were testing changes to make sure clients leave with an appointment booked. This creates a closed loop system, where follow-up and outreach can still happen even when there is a “no show”.
Quibble Creek OAT and Roshni Clinic are focused on testing change ideas that increase efficiency. They are trying to text clients instead of making phone calls, and created a stamp with instructions for the pharmacist when doses of OAT are missed.
The BOOST Collaborative is also trying to do more than simply put a face to the name of the individuals the quality improvement project aims to help-people living with opioid use disorder. There is a strong emphasis on including patient, family and community voices in all aspects of the work.
Deb Bailey, a member of the BOOST Working Group and Moms Stop the Harm who lost her daughter to a drug overdose, spoke to the risks of placing privacy and confidentiality above all else. She said that family or support networks could make a big difference.
Dr. Sharon Vipler, Medical Co-Lead for BOOST and Regional Division Head for Fraser Health Addiction Services, spoke to the importance of trauma-informed care for addressing the needs prevalent among individuals facing substance use disorders. Research has shown links between trauma and substance use disorders, and experiences of abuse and violence can be common. Trauma-informed care includes creating welcoming spaces that offer choice and control to patients or clients accessing services, as well as opportunities for learning wellness and coping skills.
As the opioid crisis continues in BC, the work of the BOOST teams remains relevant and critical. The BC Coroner’s Office has reported a slowdown in overdose deaths during the first quarter of 2019, with 34% decrease over the number of deaths occurring in March 2018 (158) and a 42% increase over the number of deaths occurring in February 2019 (73). Sadly, there were still 104 suspected drug overdose deaths in March 2019.
The BC-CfE would like to extend a huge thanks to all the teams who presented (pictured left to right – Alouette, AVI Westshore, Vancouver Native Health, Quibble Creek, VIHA Health Connections, Guy Felicella, Cornerstone Clinic, RAAC at St. Paul’s).