Emergency Department and Bridge Clinic Services (C2319) - KORE/SORII Bridge

D. OUD Training and Education 1. Provide buprenorphine waiver training courses to UK residents and nurse practitioner students. Medical students will also be invited to participate as well as UK faculty. a. The waiver training shall encompass regulations around use of the three (3) FDA-approved medications to treat OUD, pharmacology of buprenorphine, patient assessment (e.g., components of an initial evaluation, objective measurement of opioid withdrawal, distinguishing between substance-induced psychiatric disorders versus comorbid independent non-substance psychiatric disorders) and monitoring (e.g., urine drug testing, use of state prescription drug monitoring report, evaluation of patient goals, craving, withdrawal, other non-opioid substance use). b. Waiver trainings will be conducted by UK faculty with experience conducting waiver trainings and treating patients with OUD and other substance use disorders. c. Teach contingency management, an evidence-based treatment for SUD, at waiver training with use of the fishbowl technique (drawing names out of a fishbowl) to reinforce attendance and participation. d. Encourage discussions about racial/ethnic disparities and how we as providers can encourage improved access 2. Develop an Objective Structured Clinical Exam (OSCE) for a patient presenting with evidence of OUD. a. The OSCE will be developed and offered in pilot phase to UK medical students (third year or fourth year students) with the aim, upon completion of the exercise, of learners being able to perform a targeted assessment of a patient meeting DSM 5 Criteria for OUD. b. The OSCE shall utilize an already-developed Checklist Discussion Aide, similar to the Serious Illness Conversation Guide (Ariadne Labs) widely used for goals of care discussions, that would emphasize patient-centered and non-stigmatizing language and question prompts for the evaluation of a patient with suspected SUD. Feedback from students and standardized patients, as well as video-captured OSCEs, would be gathered with the goal then of dissemination of session materials to other medical schools throughout the state for their consideration of implementation. 3. Pilot an Interprofessional Education rotation on UK’s new Inpatient Addiction Medicine Consultation Service. a. Eligible students would include those from UK nursing (e.g., nurse practitioner and physician assistant students, social work, and pharmacy). b. The 1-2 week pilot rotation with the inpatient addiction medicine consultation service at UK shall develop cross-disciplinary curricula to address: evidence-based inpatient screening for opioid and other SUDs, pre-discharge naloxone training, discussion of importance of avoiding stigmatizing language and avoidance of shaming and punishment (as evidence base does not support the utility of these practice behaviors), understanding role of peer and recovery support services and how to collaborate with other interprofessional team members, and harm reduction patient education. c. Following implementation and integration of student feedback, the goal would be to share the curricula with faculty of Kentucky’s other nursing, social work, and medical schools d. Encourage discussions about racial/ethnic disparities and how we as providers can encourage improved access e. Develop an educational module on racial/ethnic disparities in OUD treatment for learners rotating through the First Bridge Clinic and staff