By Mark Powell
A Continuum of Care for Patients After an Overdose
When you’re dealing with someone experiencing an opioid overdose, time is critical. Minutes can feel like hours; seconds are incredibly precious. The community and public health consulting firm the Mosaic Group decided to do something to increase the chances of recovery following an overdose.
Its Fast Track treatment initiation and referral model was developed in response to Baltimore City’s opioid use disorder and overdose death epidemic. It begins with medication-assisted treatment in the emergency room, then connects the patient to ongoing care through a network of same- or next-day referral partnerships.
Fast Track is an integral component of the Mosaic Group’s comprehensive system of care coordination. When a patient screens positive for opioid use disorder or is brought to the emergency room with a suspected opioid overdose, a trained peer recovery coach arrives to provide support, discuss initiating treatment, and provide education about the opioid overdose reversal medication naloxone. For patients interested in initiating treatment, the peer recovery coach supports them through buprenorphine induction right there in the emergency room. For overdose survivors not interested in immediate treatment initiation, the peer recovery coach follows up with them for 90 days as part of the Overdose Survivors Outreach Program. This relationship engages patients in support, care, harm reduction education, and treatment if and when they become interested in initiating.
The Mosaic Group has worked with eleven hospital systems in Baltimore to develop induction dosage protocols based on the Clinical Opiate Withdrawal Scale and to engage a network of over 25 Fast Track buprenorphine providers for same or next-day referrals to ongoing care. This means that even if a patient receives their first dose of medication in the emergency room late at night, a provider is in-place for early morning follow-up and stabilization. Additionally, the Mosaic Group developed protocols for the referral paperwork and medical communications, to ensure that even in a busy urban emergency room the Fast Track system is readily accessible to the care team.
“Mosaic Group is very encouraged by the promising outcomes associated with our Fast Track MAT initiation in the ED model of care and is working diligently to understand the key factors contributing to these outcomes to support further model enhancement and expansion,” says Marla Oros, Mosaic Group’s founder.
It all comes down to those precious minutes Fast Track utilizes to reach overdose patients. Because they can lead to years of recovery.
Mosaic Fast Track was a featured award winner in the 2019 Innovation Now project of the Addiction Policy Forum.
J. Mark Powell is an author, former network journalist, and veteran communications expert.