Implementation facilitation (IF) is a multi-faceted strategy that enables and supports individuals or organizations in the adoption of evidence-based practices through interactive problem-solving and support. Studies have evaluated the use of implementation facilitation for buprenorphine in several contexts, including Project ECHO, a tele-mentoring model to expand capacity for treating specific health conditions, to primary care clinicians, and implementation facilitation to support buprenorphine prescribing from the emergency department and in Veterans Affairs clinics.

Organizations have built dedicated addiction medicine consultation teams to support provision of medications for opioid use disorder during hospitalization or at primary care appointments. In many instances, these consult teams also include resource support for a dedicated nurse care manager. In the CATCH hybrid implementation trial, 6 public hospitals in New York were provided with resources to support a dedicated addiction medicine consultation team comprised of an addiction medicine physician, social worker, and peer counselor. The Primary Care Opioid Use Disorders treatment (PROUD) trial evaluated implementation of a collaborative care model using a nurse care manager to support medication prescribing for OUD in primary care in 6 diverse health systems across 5 US states. Implementation strategies used to support the uptake of addiction medicine consult teams generally consist of teaching and technical assistance (TTA) and funding for a clinical champion and case manager.

Implementation strategies under the broad umbrella of education and training include conducting local needs assessments, conducting educational meetings with different stakeholder groups, conducting educational outreach visits, creating a learning collaborative to support ongoing discussion and troubleshooting, and giving individualized performance feedback to sites and /individuals. These implementation strategies aim to address the common barriers of limited existing knowledge of and familiarity with buprenorphine prescribing among healthcare providers new to the practice, and can help to reduce stigmatizing beliefs surrounding individuals with opioid use disorder.

Common implementation strategies accomplished through modifications of the electronic health record system include developing tools to assist in clinician buprenorphine dosing, facilitating the relay of clinical data to providers, building tools for quality monitoring, and making billing easier.

Identifying and engaging a clinician champion in the local context can assist in buprenorphine program implementation by engaging peers, leading by example, and serving as a convenient go-to foror questions and support. This is particularly valuable because one of the most common barriers identified in buprenorphine prescribing is a lack of familiarity or experience with the practice. Stigmatizing beliefs among peer clinicians can also be reduced with greater and more regular exposure to the practice via the clinical champion.