What is Head Start? Head Start, a federally funded program of the United States Department of Health and Human Services, promotes school readiness and family well-being in children from birth to age five who meet specific criteria. Lowell Head Start Partnership The Lowell Head Start program is engaged in efforts to combat the opioid epidemic after an incident involving an overdose by a parent in the center. To support the Lowell Head Start program, our team forged collaborations with facilities close to Head Start in Lowell by creating informational pamphlets that detail services offered to people with substance use disorders in Lowell. Opioid trends in Lowell Lowell is a very diverse city, with 40% of the population being non-white and 25% being foreign born. Lowell has a highest poverty rate at 19.1%, in the region, a low median household income at $49,164, and a high rate of unemployment according to the 2016 greater Lowell community health needs assessment (CHNA). Opioid overdose death rate in Lowell is 43 fatalities per 100,000 – a rate greater than double the average fatality rate in the state of Massachusetts. Quick overview of project To capitalize on the statewide and local efforts to bring opioid addition out in the open, the presenters created an informational pamphlet as a resource and educational tool for families that seek or are referred for services. Description of many relevant provisional services are expanded upon in the capstone project submission – including detox, hotline and support services, medication management, behavioral health, counseling and relapse tools training. Additionally, the presenters actively forged connections with local community organizations serving those struggling with opioid use disorder. Please see capstone document for additional information regarding specific resources. Conclusions With the significant rise in fatal overdoses in the city of Lowell, many departments and programs have been developed to combat the opioid epidemic. This project aims to provide vital information to the Head Start Program and the families they serve, and to provide established resources available in Lowell, such as medication disposals, Narcan and signs of overdose training, needle drop-off services, available hotlines, and city-wide programs, including Lowell Community Opioid Outreach Programs, MA Opioid Abuse and Prevention Collaborative of Greater Lowell, and Partnerships for Success Program.

In the mid-1980s, the anesthesia departments at hospitals affiliated with Harvard Medical School were faced with a challenge: mounting medical malpractice costs. Malpractice insurance was provided by the Controlled Risk Insurance Company (CRICO), a patient safety and medical malpractice insurance company owned by and providing service to the Harvard medical community. CRICO spearheaded an effort to reduce these costs and ultimately found a way to decrease the risks associated with anesthesia. Here, we chronicle events that led to the dramatic changes in medical practice that resulted from the activities of a small group of concerned anesthesiologists at Harvard-affiliated hospitals. We place these events in a historical perspective and explore how other specialties followed this example, and end with current strategies that minimize the risk associated with anesthesia. We conducted interviews with principals who formulated original standards of patient monitoring. In addition, we consulted documents in the public domain and primary source material. Efforts of these pioneers resulted in the establishment of the seminal Harvard-based anesthesia monitoring standards for minimal monitoring. What followed was an unprecedented transformation of the entire field. After the implementation of these standards at Harvard-affiliated hospitals, the American Society of Anesthesiologists (ASA) adopted "Standards for Basic Anesthetic Monitoring" for use during the administration of all anesthetics in the United States. Other nations have since adopted similar guidelines and these practices have resulted in significant improvements in patient safety. Currently, we estimate mortality due to anesthesia in healthy patients to be 1:400,000-perhaps as much as 10 times lower since the early 1980s. What began as an attempt to lower medical malpractice costs in a group of university hospitals became a worldwide effort that resulted in improvements in patient safety. Other specialties have adopted similar measures. Currently, an attitude and appreciation of safety are exemplified by several practices that include among others-the adherence to these patient safety guidelines, simulator training, the promulgation of standards and guidelines by ASA, and the use of a safety checklist before induction of anesthesia.