Use validated verbal screening and assessment tools to evaluate all pregnant women for substance use disorders

by Candy Stockton-Joreteg, Carrie Griffin

Once substance use is identified, perform a brief intervention and referral to appropriate treatment (SBIRT)

by Candy Stockton-Joreteg, Carrie Griffin

Maternal urine toxicology and the role of explicit/implicit bias in decision-making

by Elliott Main, Holly Smith, Scott Haga, Tipu V. Khan

Create a prenatal checklist for care of women with opioid use disorder

by Elliott Main

Identify substance-exposed newborns

by David Golembeski, David Kim, Helen DuPlessis, Jadene Wong, Robert Castro, Vaneet Kalra

Implement selective newborn biological toxicology testing

by David Golembeski, David Kim, Helen DuPlessis, Jadene Wong, Robert Castro, Vaneet Kalra

Implement Trauma-Informed Care to optimize patient engagement

by Holly Smith, Margaret Yonekura

Understand and implement the principles of Motivational Interviewing

by Helen DuPlessis

Encourage breastfeeding for women with opioid use disorder

by Jacqueline Rad, Martha Tesfalul, Mimi Leza, Pamela Flood

Initiate medication assisted treatment in the prenatal setting

by Holly Smith, Tipu V. Khan

Implement an inpatient treatment protocol for pregnant women with opioid use disorder

by Candy Stockton-Joreteg, Holly Smith, Martha Tesfalul, Tipu V. Khan

Implement evidence-based anesthesia practices in the peripartum period for opioid use disorder in pregnancy

by Mark Zakowski, Pamela Flood

Ensure methadone and buprenorphine doses are not tapered in the immediate postpartum period

by Mark Zakowski, Scott Haga, Tipu V. Khan

Implement care pathways for peripartum and postpartum pain management for pregnant patients without opioid use disorder to minimize opioid use

by Dorothy DeGuzman, Elliott Main, Mark Zakowski, Pamela Flood

Utilize shared decision making to tailor post-procedure pain control

by Mark Zakowski, Pamela Flood, Tipu V. Khan

Implement a non-pharmacologic bundle of care for neonatal abstinence syndrome for medical staff and parents to follow

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Develop guidelines for inpatient monitoring of newborns managed with a non-pharmacologic bundle of care

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Consider parental rooming-in with the newborn when safety of mother and newborn can be ensured

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Prioritize measurement of functional impairment as a basis for initiation and escalation of pharmacologic treatment

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

If pharmacotherapy is indicated, consider a trial of morphine every 3 hours PRN as an initial strategy for the treatment of neonatal abstinence syndrome instead of scheduled dosing or more long-acting pharmacotherapy options

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Consider methadone as first-line pharmacotherapy for the treatment of neonatal abstinence syndrome following evaluation of its benefits/risks

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Consider clonidine instead of phenobarbital as a potential second line/adjunctive therapy for neonatal abstinence syndrome

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Develop guidelines for inpatient monitoring of newborns receiving morphine, clonidine, or methadone pharmacotherapy prior to discharge

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Establish a pharmacotherapy weaning protocol

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Identify community care resources for the mother and newborn

by Jadene Wong, Katherine Weiss

Codevelop a multidisciplinary peripartum plan of care for pregnant women on medication assisted treatment and ensure a warm handoff to the hospital

by Martha Tesfalul, Tipu V. Khan

Implement opioid use disorder discharge checklists for all hospital-based points of entry

by Elliott Main, Jacqueline Rad

Continue to establish a therapeutic relationship with parents/caregivers once the infant has been born and empower parents to be involved with the care of their newborn

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Develop a dyad-centered Plan of Safe Care

by Heather Briscoe, Helen DuPlessis, Jacqueline Rad, Kelly Brandon, Mimi Leza

Implement a warm handoff strategy to follow at time of discharge

by Christina Oldini, Mimi Leza

Ensure linkage to home visitation programs or that other in-home supports are in place

by Emillie R. Feenan, Jacqueline Rad, Mimi Leza

Ensure referral and linkage to other necessary services/resources at discharge

by Emillie R. Feenan, Jacqueline Rad, Mimi Leza

Communicate directly with the outpatient primary care provider prior to the newborn leaving the hospital to review the hospital course and discuss follow-up

by Alexandra Iacob, Angela Huang, Kathryn Ponder, Lisa Chyi, Pamela Aron-Johnson, Priya Jegatheesan

Provide staff and provider education on opioid use disorder

by Jennifer Carraher

Educate patients and families about opioid use disorder

by Carrie Griffin, Lorena Watson

Educate pregnant women about opioid use disorder in pregnancy and the hospital experience

by Lorena Watson, Martha Tesfalul

Provide health care providers with stigma education/resources

by Lauren Caton

Educate pregnant women and families about neonatal abstinence syndrome and the newborn hospital experience

by Jadene Wong, Katherine Weiss

Educate clinical providers and staff about neonatal abstinence syndrome

by Jadene Wong, Katherine Weiss