Research

Vancouver General Hospital launched an emergency department (ED) Peer Support Worker (PSW) program on November 25, 2024, to improve care for patients who use substances. This initiative aims to address barriers such as stigma and discrimination by creating a more welcoming and supportive ED environment.  

Led by Dr. Jessica Moe in collaboration with VGH operational leadership, this study evaluates the feasibility and impact of integrating peers with lived experience of substance use into the ED to provide trauma-informed, person-centered support for patients. The study examines patient and provider experiences with the PSW program, examines how it impacts patient care, and provides insights to help the ED team refine and optimize services. It also assesses the program’s potential to reduce the number of patients who leave the ED before medically advised. 

The study assesses whether PSWs can enhance patient engagement, harm reduction service delivery, improve treatment adherence, and increase comfort. To evaluate these outcomes, the research team is collecting data from multiple sources. 

The research team invites patients who interact with a PSW to complete surveys exploring their level of comfort, care experiences, and engagement with PSWs and harm reduction services. The study also centers Indigenous voices through sharing circles and storytelling sessions with patients who identify as Indigenous and have interacted with a PSW. This approach ensures the program is informed by people with lived and living experience and reflects culturally safe, trauma-informed practices.

To ensure a comprehensive understanding of the program’s impact, the study includes focus groups with healthcare providers and surveys with PSWs and hospital leadership to capture diverse perspectives and identify areas for improvement. In addition, we developed standardized patient interaction logs that PSWs complete as part of routine care. We review this data to better understand the nature of peer support interactions and patient needs.  

We are also using administrative health data to examine patient-related outcomes, including whether patients leave the ED before medically advised. By evaluating patient and healthcare provider experiences, PSW documentation, and administrative data, this study examines feasibility and guides refinement of the ED PSW program, contributing to more inclusive and effective emergency care for people who use substances. 

Observing from Afar: Continuous Pulse Oximetry for People Who Smoke Opioids to Prevent Overdose Deaths (Oximetry Study)

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In 2021, 2232 people died of an overdose in British Columbia (BC), the highest annual death toll on record.* Smoking opioids has become the most common way to consume opioids, and the proportion of overdose deaths from smoking unregulated drugs increased from 31% to 56% between 2016 and 2020.*

Given the rise in smoking-related deaths during the coronavirus disease (COVID-19) pandemic, our project responded to an urgent need to develop a remote monitoring system that maintains physical distancing and is effective and feasible for staff to implement at overdose prevention services (OPS) when monitoring and responding to people who smoke drugs. Continuous pulse oximetry enables real-time, remote oxygen level monitoring for patients in healthcare settings. Introducing this technology at OPS for individuals smoking drugs may promote service use and improve staff safety by allowing monitoring from a safe distance.

This project implemented a novel continuous pulse oximetry monitoring protocol using a participatory research approach to improve services at OPS for people who smoke opioids. The four partnering OPS from Victoria and Vancouver successfully implemented our protocol. The project improved capacity and comfort levels among peer researchers, participants, and OPS staff in the use of continuous pulse oximetry.

Our study offers crucial lessons about engaging people with lived experience in participatory research on people who smoke opioids. We engaged people with lived experience in every aspect of the study.

Toward The Heart Project Summary: https://towardtheheart.com/research-projects

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