Organizations have built dedicated addiction medicine consultation teams to support the provision of medications for opioid use disorder during hospitalization and facilitate linking individuals to ongoing care following discharge. Addiction medicine consult teams are best described as a type of hospital-based opioid treatment delivery structure rather than an implementation strategy; however, we mention them here because many studies have evaluated implementation outcomes related to addiction medicine consultation teams. In the CATCH hybrid implementation trial, six public hospitals in New York were provided with resources to support a dedicated addiction medicine consultation team, comprising an addiction medicine physician, social worker, and peer counselor. The START pragmatic trial is currently assessing a similar implementation effort at three geographically diverse hospitals in California, New Mexico, and Massachusetts. 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. 

External practice facilitation empowers local organizations to adapt and build their own approach to implement the provision of medications for opioid use disorder through linking to a central hub of expert advisers. A hybrid implementation trial is currently evaluating the effectiveness of external practice facilitation conducted by four state implementation hubs to support hospital-based provision of medications for opioid use disorder among 24 community hospitals. Researchers are comparing external practice facilitation, combined with monthly tele-mentoring, to a low-intensity implementation strategy that consists only of basic training and education. Other studies have adapted Project ECHO (Extension for Community Healthcare Outcomes), an existing telementoring network that links local clinicians with experts in the management of complex conditions, to improve the provision of medications for opioid use disorder in hospital and jail settings.

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.