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Multidisciplinary Team Reviews of Drug Overdose Deaths and the Use of Minigrants to Advance Recommendations

A Statewide Pilot in Rhode Island

Hackman, H. Holly MD, MPH; Koziol, Jennifer A. MPH; McCormick, Meghan MPH; McDonald, James V. MD, MPH; Green, Traci C. PhD, MSc

Journal of Public Health Management and Practice: October 31, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000001081
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Context: Rhode Island has been significantly impacted by the opioid epidemic, ranking 11th in unintentional drug overdose rates in the United States in 2017. Illicit fentanyl was involved in the majority of these deaths.

Program: To enhance surveillance of this epidemic, the RI Department of Health piloted in-depth, multidisciplinary, and multiagency team reviews of drug overdose deaths. The goals were to identify gaps in policies and programming and develop recommendations to prevent future deaths. Time-sensitive minigrants were offered to nonprofit organizations as a novel way to further the recommendations put forth from these reviews.

Implementation: Legal agreements between select state agencies and institutions enabled broad team representation and the sharing of information during each meeting. Reviews, revolving around a common theme, were conducted for up to 10 deaths each quarter. Recommendations for prevention were generated by the team and summarized in a report to the Governor's Overdose Prevention and Intervention Task Force and the public within 1 month of each meeting. Announcements of minigrant opportunities and funding to advance the community-specific recommendations were paired with each meeting.

Evaluation: From November 2016 through May 2018, the pilot team convened 7 times, generated 78 recommendations, and distributed 31 minigrants. Early process evaluations of these grants have shown positive impact within local environments. Following the pilot phase, state legislation for these reviews was passed in June 2018.

Discussion: The RI Department of Health was able to successfully pilot a multidisciplinary review process for overdose deaths and has recently institutionalized this process through legislation. The successful implementation of many of the team's community-oriented recommendations, supported through a minigrant process, highlights the impact that small financial investments can have to address the opioid epidemic and may be a model for other jurisdictions seeking to advance recommendations from these types of reviews.

Injury Prevention Center, Boston Medical Center, and Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts (Drs Hackman and Green); Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts (Dr Green); and Rhode Island Department of Health, Providence, Rhode Island (Mss Koziol and McCormick and Dr McDonald).

Correspondence: H. Holly Hackman, MD, MPH, Injury Prevention Center, Boston Medical Center, and Department of Emergency Medicine, Boston University School of Medicine, BCD Bldg, 800 Harrison Ave, Boston, MA 02118 (holly.hackman@bmc.org).

This work was supported by CDC Cooperative Agreement no. 6 NU17CE002740-04-01.

The authors have no potential conflicts of interested to disclose.

The authors acknowledge Nicole Robertson, formerly of the Boston Medical Center, for her assistance in the implementation of this project; the staff of the Office of the State Medical Examiner at the Rhode Island Department of Health for their logistical support; and the MODE team members for contributing their time and expertise to this pilot.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.