{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:12:45Z","timestamp":1788329565808,"version":"build-2803163510"},"reference-count":58,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08DA049905"],"award-info":[{"award-number":["K08DA049905"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In\u2010hospital opioid use disorder medication (MOUD) initiation remains low despite its effectiveness to reduce mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Assess whether a non\u2010interruptive electronic health record (EHR)\u2010embedded intervention with supportive education and outreach increased in\u2010hospital MOUD initiation without disrupting clinical workflow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this mixed\u2010methods study across 12 hospitals, we conducted an interrupted time series analysis of hospitalizations involving OUD and\/or opioid poisoning. We condcuted a directed content analysis of interviews from 60 hospital\u2010based clinicians, social workers, nurses, and pharmacists. The intervention involved MOUD initiation orders, discharge naloxone orders, and access to local OUD treatment resources. Strategies for adoption included clinican and nurse OUD education and required nurse trainings for Clinical Opiate Withdrawal Scale (COWS) assessments. Outcome measures included monthly changes of inpatient methadone administration \u226530\u2009mg, discharge buprenorphine and naloxone prescriptions, and COWS assessments. Emergent themes from qualitative data provided context and possible explanations for quantitative results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From January 2021 to September 2024, there were 450,790 hospitalizations; 3.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913,902) involved OUD\/opioid poisoning; and, of these, 19.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092750) involved MOUD. Between the pre\u2010 and post\u2010intervention periods, there was no significant change in monthly methadone administrations or discharge naloxone prescriptions. Monthly buprenorphine discharge prescriptions decreased from 10.5% to 8.2% (slope decrease: \u22120.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) in the post\u2010implementation period. In the immediate post\u2010intervention period, monthly COWS documentation increased from 7.3% to 14.5% (level change: 6.87;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Qualitative findings reflected a lack of intervention awareness due to limited leadership communication across hospitals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A non\u2010interruptive EHR\u2010embedded intervention with supportive education and outreach was insufficient to increase MOUD initiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70289","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T07:31:51Z","timestamp":1771572711000},"page":"982-994","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A mixed methods assessment of an electronic health record\u2010embedded intervention with supportive education and outreach to increase in\u2010hospital opioid use disorder treatment initiation"],"prefix":"10.1002","volume":"21","author":[{"given":"Susan L.","family":"Calcaterra","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Hospital Medicine, University of Colorado Aurora Colorado USA"},{"name":"Department of Medicine Division of General Internal Medicine, University of Colorado Aurora Colorado USA"},{"name":"Adult and Child Center for Health Outcomes Research and Delivery Service University of Colorado School of Medicine and Children's Hospital Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Health Outcomes Research and Delivery Service University of Colorado School of Medicine and Children's Hospital Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Grimm","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Hospital Medicine, University of Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi Summers","family":"Holtrop","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Health Outcomes Research and Delivery Service University of Colorado School of Medicine and Children's Hospital Colorado Aurora Colorado USA"},{"name":"Department of Family Medicine University of Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1399-2881","authenticated-orcid":false,"given":"Angela","family":"Keniston","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Hospital Medicine, University of Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado Aurora Colorado USA"},{"name":"Rocky Mountain Poison and Drug Center Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-3363","authenticated-orcid":false,"given":"Jacob A.","family":"Lebin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado Aurora Colorado USA"},{"name":"Rocky Mountain Poison and Drug Center Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid A.","family":"Binswanger","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of General Internal Medicine, University of Colorado Aurora Colorado USA"},{"name":"Institute for Health Research, Kaiser Permanente Colorado Aurora Colorado USA"},{"name":"Colorado Permanente Medical Group Denver Colorado USA"},{"name":"Department of Health Systems Science Kaiser Permanente Bernard J. 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