"Anthony" a 55 year old patient was arrested and transferred to our jail ED for abdominal pain and vomiting, with his arresting officers not recognizing opioid withdrawal. He stated he had been on heroin for decades and wanted to get "clean." He'd been chronically homeless, and arrested multiple times for crimes of acquisition for his opioid use disorder, spending a few days to weeks in jail each time.
Because of our ED-Bridge discussion with our resident physicians, Nicole a third year Emergency Medicine resident, recognized that she could do something to change this pattern. Previously, she would have ordered "comfort care" medications and would tell the patient "there's nothing we can do, sorry!" This time, she started buprenorphine, providing immediate care to patients. She also linked him to services in the jail and on release from jail. She told Anthony that he could come back to our ED any time and get care.
Nicole provided feedback to me that she felt for the first time that we were "finally doing the right thing for our patients in custody", and wanted to let everyone involved in the project that she was thankful for the opportunity.