Meeting Patients in the Field Opioid Use Intervention from Emergency Service Personnel
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Abstract
Introduction: Over the past two decades, the opioid epidemic has posed a major public health crisis in the United States, with significant economic, physical, and societal burdens. This quality improvement (QI) initiative aimed to address gaps in opioid use disorder (OUD) management by enhancing emergency medical services (EMS) personnel's ability to support medications for opioid use disorder (MOUD) access and connection to outpatient services.
Methods: The project was implemented in a small suburban fire department in Virginia. Using the Donabedian Model, Theory of Planned Behavior, and Knowledge-to-Action framework, a structured educational intervention was delivered to EMS personnel across four operational shifts. Pre- and post-intervention surveys assessed knowledge, attitudes, and confidence using validated tools. Paired t-tests and descriptive statistics were used for quantitative analysis, and thematic analysis was applied to stakeholder meeting notes and qualitative feedback.
Results: Post-training surveys showed statistically significant increases in EMS provider confidence. Confidence in identifying appropriate patients for MOUD increased by 24.9%, t(28) = -5.01, p <.001, and confidence in providing resources to patients with OUD increased by 37.5%, t(28) = -4.93, p < .001. Thematic analysis revealed six primary themes: improved training effectiveness, increased resource awareness, barriers to implementation, sustainability planning, community engagement, and enhanced data tracking.
Conclusion: This QI initiative demonstrated that brief, targeted EMS training on MOUD significantly improved provider confidence and readiness to support OUD patients. The project highlights EMS’s potential to act as upstream intervention partners in the continuum of care. Broader implementation and system-level integration are recommended.
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