Setting
The implementation of methadone initiation or continuation programs is most ideal in settings where staff come in contact with high numbers of individuals who use opioids (such as hospitals or prisons) and can be impacted by existing organizational structures or workflows within institutions.
Barriers
Hospital-based staff seeking to implement methadone and other medications for opioid use disorder programs have cited ongoing staff shortages and increased workloads relevant to non-opioid related clinical tasks as a significant barrier to also taking on new duties.
Facilitators
Hospital-based providers have cited that electronic health record optimizations, such as order sets and clinical scoring tools, would facilitate the administering and prescribing of methadone.
Hospital-based providers have cited that the successful implementation of medication initiation in other departments within their own hospital (such as the emergency department) or in other similarly structured hospitals helped them feel more confident that they would be able to overcome barriers in their own setting.
Support from an organization leader or executive champion can reduce administrative hurdles by expediting approval processes, allocating additional resources, and prioritizing the effort among the organization’s multiple other competing priorities.