Written by Elizabeth Cairns, Mobilize Recovery Special Projects, and reviewed by Code Recover Peer Advisors, August 2026

Peer recovery support specialist Christy Reser talks about how a successful transfer of care helps patients and builds trust with the clinical staff

Peer recovery support specialist Christy Reser talks about a peer's journey from ER bedside to warm handoff

In a traditional ED visit, a patient is often given a stack of discharge papers and a list of phone numbers to call when they leave. For someone in the middle of an opioid crisis, this approach is a recipe for failure. A “warm handoff” is a personal, active transfer of care. It means that before the patient leaves the hospital, they have a confirmed appointment, a way to get there, and a real human being on the other end of the line waiting for them.

To execute a warm handoff effectively, you aren't just giving information; you are removing obstacles. Use this checklist for every patient:

• Immediate Connection: While the patient is still in the room, call the receiving clinic or the Recovery Community Organization (RCO). If possible, let the patient speak briefly with the person they will be meeting.
• Logistics Check: Use what you learned about their Social Determinants of Health. Do they have a ride? Do they have a working phone for a reminder call? If not, solve it now—coordinate a taxi, a bus pass, or a peer-led transport.
• Pharmacy Check: If the doctor wrote a prescription for buprenorphine, verify which pharmacy is open and has it in stock. Many patients "fall off" because they show up to a pharmacy that can’t fill their script.
• First Dose Orientation: If they received their first dose of buprenorphine in the ED, explain how they will feel over the next 24 hours. Knowing what to expect reduces the fear that leads to using again.
• Follow up: Call the patient within the first 24 hours to make sure everything went as planned and troubleshoot anything that didn’t. 

Closing the Loop with the Team

A warm handoff isn't finished until the medical team knows the plan. Once you have the follow-up secured, update the nurse or doctor. This reinforces your value to the clinical team and ensures the discharge summary includes the correct follow-up instructions. This handoff is what transforms a 15-minute clinical intervention into a long-term recovery trajectory.