Advancing Linkage and Retention in Care in Health Systems

Abstract: We are applying as a site for the Substance Use Disorder (SUD) Linkage and Retention Project. The University of Kentucky (UK) is a tertiary referral center with 950 beds and a dedicated addiction medicine consult service (staffed by hospitalists) for a catchment area in Kentucky, Ohio, Indiana, Tennessee and West Virgina at the center of the opioid crisis. Our team is applying for all three clinical settings (inpatient, pharmacy and outpatient) and for the purpose of this project, we will engage an inpatient team, comprised of board-certified addiction medicine hospitalists, a social worker, and a nurse navigator, as well as an outpatient addiction medicine physician and an addiction medicine-pharmacist. We have a robust linkage system that has evolved over the last five years and includes clinic sites in all five states. Our current process includes screening patients for opioid use disorder (OUD) and stimulant use disorder (StUD), offering evidence-based interventions with a patient- involved approach, and linking them to care after discharge. We have been successful in implementing all three medications for opioid use disorder (MOUD) including extended-release buprenorphine injections. While we have overcome several barriers, including increasing our outpatient referral sites beyond UK, and have a high follow up rate, our patients continue to encounter barriers to treatment of SUD. The goal of this project is to increase linkage and retention in care over all three sites, as well as to develop an algorithm that can be applied to other hospitals on a national level.