Dieujuste N, Johnson‐Koenke R, Christopher M, et al. - This study was intended to leverage the existing veterans health administration (VHA) opioid safety initiative (OSI) and investigate a novel emergency Department (ED)‐based quality improvement (QI) program to decrease opioid prescribing in multiple ED settings. Researchers designed a quasi‐experimental study of phased‐in implementation of a quality improvement ED‐based OSI. A dashboard was developed and disseminated to evaluate ED‐specific prescribing rates and an ED‐tailored toolkit to implement the program. Change in ED‐provider prescribing rate of opioids was assessed for patients discharged from the ED, by provider and aggregated up to facility‐level, pre‐ and post‐implementation. The data revealed that the ED is an important site for QI programs as well as the implementation of opioid safety measures, due to the high volume of patients and the vital role the ED plays in patient treatment and hospital admissions. Results suggest that implementation of a national Veterans Affairs (VA) ED OSI implementation is useful practice.