Evolution of a Post-Overdose Outreach Program in King County, Washington: Lessons Learned Through Continuous Quality...

Area of Science:

• Public Health
• Emergency Medicine
• Addiction Services

Background:

• Overdose survivors face high risks of subsequent overdose and death.
• Post-overdose outreach programs aim to connect survivors with harm reduction and treatment services.
• Existing programs vary in design and effectiveness.

Purpose of the Study:

• To assess and improve a phone-based post-overdose outreach model in King County, Washington.
• To utilize a continuous quality improvement (CQI) process for program enhancement.
• To evaluate program indicators and costs through iterative adaptations.

Main Methods:

• Utilized King County Emergency Medical Services (KC-EMS) records to identify eligible patients.
• Implemented three sequential Plan-Do-Study-Act (PDSA) cycles with varying outreach strategies and eligibility criteria.
• Measured program indicators and costs per month, per eligible patient, and per referred patient.

Main Results:

• The initial phone-based pilot had low referral rates (2/month).
• Automated texting and expanded eligibility in Phase Two increased referrals (3/month).
• Phase Three achieved the highest number of eligible patients (405/month) and referrals (4/month) with reduced costs per referred patient ($279).

Conclusions:

• CQI and PDSA cycles effectively identified adaptations to improve outreach program efficiency.
• Phone-based post-overdose outreach presents challenges in patient referral.
• The study underscores the value of CQI in program operations and the need for multi-pronged overdose prevention strategies.