A Syringe Service Program Within a Federal System: Foundations for Implementation.

BACKGROUND Drug use, specifically opioid use, is a public health crisis in the United States. Harm reduction programs, including syringe service programs, show efficacy in improving individual and public health outcomes. Healthcare provider perceptions are an important initial assessment when considering implementing a syringe service program. OBJECTIVE The objective of this quality improvement project, completed in a Northeastern Veterans Affairs Medical Center (NEVAMC), was to lay the groundwork for implementation of a syringe service program. METHODS This multiphase project included an initial needs assessment with stakeholders to determine the scope of substance use disorder within the facility and initiated the change process needed for syringe service program implementation. We administered an online survey, the Drug and Drug Problems Perceptions Questionnaire (DDPPQ), to better understand staff perspectives of and comfort in working with people who use drugs. Two educational modules were developed and conducted for staff to increase their knowledge, skills, and trauma-informed practices when working with people who use drugs. Standardized document templates for program implementation in federal systems were also developed. RESULTS The needs assessment identified 266 patients who could benefit from expanded harm reduction services and a recognition that staff perception be assessed within the facility. The DDPPQ, completed by 153 staff members, indicated positive perceptions of people who use drugs and ability to counsel/treat people who use drugs. The median DDPPQ total score was 73, indicative of an overall positive perception. Sixty-eight staff members attended the initial education session, and 35 attended the second session designed specifically for mental health service line professionals. CONCLUSION The findings indicate NEVAMC staff members have a high level of comfort working with people who use drugs. The staff educational programs were well received and have become a part of routine staff training at the NEVAMC. The standardized document templates are available for persons developing a syringe service program within a federal system.