Thursday, November 21, 2024
11/21/2024
Beta to Alpha is a project of Baylor Research Institute (BRI) for Baylor Scott and White-Fort Worth (BSW-FW) Emergency Department (ED) to create system changes to increase opioid alternatives for ED patients. The project will create a MOUD (Medication for Opioid Use Disorder) Bridge Clinic for patients with Opioid Use Disorder (OUD) to promote their recovery. The project will begin as a "Beta" project in Fort Worth, Texas, and expand as an "Alpha model" to two other EDs in North Texas. BSW is the 12th largest healthcare system in the country and the largest healthcare system in Texas. With funding, SAMHSA can learn how to disseminate best practices for OUD across very large healthcare systems for maximum impact. The population to be served are patients who visit the BSW ED with painful conditions. More than 17,000 patients visited the BSW ED last year with painful conditions. Overall, BSW-FW prescribed opioids over 25,000 times in the ED or hospital. The most frequent presenting painful conditions were gastrointestinal, chest pain, and trauma. 60% of patients were female. More than one-third of patients (39%) were on Medicare, Medicaid, or uninsured. The majority of patients (89%) were between 18 and 64 years old. Patients were ethnically diverse with 25% of patients being Black, 32% Hispanic, 3% Asian, 3% other races, and 37% as White. As one of the largest healthcare systems, BSW treats patients at high-risk for OUD, including people with chronic conditions that lead to pain like kidney failure, dialysis, and sickle cell disease. The project will allow SAMHSA to evaluate the effectiveness of interventions among people with chronic conditions. Strategies and interventions include all required activities and eight allowable activities. To reduce gaps and disparities in the target population identified, Beta to Alpha will: institutionalize alternatives to opioids; increase access to MOUD; improve physician training in ALTO, MOUD, SBIRT, and cultural competence; and connect patients to ongoing care for pain and MOUD. BSW will target the most common ED painful conditions for opioid treatment alternatives. BSW has developed a multi-modal pain management treatment program and an Alternative to Opioids (ALTO) pilot that reduces patient initial exposure to addictive opioids and helps patients with OUD to transition to MOUD and other pain treatments. BSW will add physical therapy consults in the ED as a new alternative to opioids. BSW will train physicians and residents in the ED in best practices for opioid alternatives. In this training, BSW will consult with the SAMHSA-funded Opioid Response Network. Training will include BSW's five residency programs. To identify patients with OUD, BSW will implement the NIDA Quick Screen and NIDA ASSIST assessment. ED physicians will offer patients with OUD an initial MOUD dose. With grant funds, BSW will pursue the Pain and Addiction Care in the ED (PACED) accreditation. In grant years 2 and 3, BSW will expand all practices to two additional EDs in North Texas. BRI will disseminate best practices across local hospitals, medical schools, the American College of Emergency Physicians, and national publications. In a pilot project, BSW was able to initially reduce opioid prescriptions by 59%. This project builds on that success. The goal of Beta to Alpha is to implement alternatives to opioids for pain management in three BSW EDs in North Texas and to reduce opioid misuse. Measurable objectives include: 1) 90% of ED providers will use alternatives to opioids more than opioids for pain management. 2) Reduce BSW targeted ED opioid prescriptions by 20%. 3) 70% of patients in the MOUD Bridge Clinic will remain opiate-free. 4) 70% of patients are connected to long-term OUD care. The total unduplicated number of patients served over the grant period is 375 (75 in year 1, 150 in year 2, 150 in year 3).
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
