(43) Innovative Interprofessional Education Model for Substance Use Disorder Care

Background & Introduction: Our Academic Medical Center identified a critical need for substance use disorder (SUD) treatment programs and educational opportunities. With 16% of the local population uninsured and many more under-insured, access to SUD treatment was severely limited, especially for individuals experiencing homelessness, who exhibit a higher prevalence of SUDs compared to stably housed individuals.

This situation underscored an urgent need to bridge both care and educational gaps. Recent studies have emphasized the critical role of interprofessional education in transforming healthcare delivery and educational outcomes. For instance, Muzyk et al. found interprofessional SUD courses improved educational outcomes and patient treatment decisions, with more patients agreeing to follow-up care. Additionally, Skochelak's review calls for comprehensive educational reforms, emphasizing integration, evaluation, new financing methods, leadership and alignment with healthcare delivery changes.

These insights inspired the creation of an innovative interprofessional academic-based clinic aimed at delivering comprehensive, evidence-based care to underserved populations while simultaneously providing a robust educational framework for medical students and residents. This initiative not only addresses immediate clinical needs but also prepares future healthcare professionals to collaboratively tackle complex challenges associated with SUDs.

Methods: Through strategic partnerships with community organizations, we established the Galveston Safe Against Fentanyl Emergencies (G-SAFE) clinic, offering comprehensive interprofessional SUD care and a robust SUD curriculum. Located within Galveston Central Church, a trusted community venue already providing essential services like hot meals and transportation, the G-SAFE clinic provides wraparound services to insured, uninsured and unhoused individuals, reaching populations not typically served by traditional healthcare systems in a space they already gather and trust.

The Interprofessional Continuity of Practice Experience (I-COPE) model integrates interprofessional education into a longitudinal continuity-of-care framework. Medical students are organized into rotating teams shadowing SUD providers, nurses, social workers, and peer-coaches or counselors. They attend bi-weekly clinic sessions, ensuring continuity-of-care and fostering sustained learning experiences. For Graduate Medical Education, all Internal and Family Medicine interns participate in a SUD curriculum during their General Medicine block, which includes virtual learning, community experiences and interprofessional teamwork at the G-SAFE clinic.

Our SUD programs are funded through a blend of protected provider time from educational and administrative full-time equivalences, philanthropy, grants and community in-kind services, overcoming traditional funding barriers. Data collected on substance use severity and clinical concerns are assessed through approved surveys (IRB-24-0010), contributing to ongoing quality improvement.

Results: In its first year, the G-SAFE clinic successfully treated 159 unique patients with SUDs, resulting in 615 encounters, and included a significant number of uninsured and unhoused individuals. Our preliminary patient cohort (n=50) had an average age of 46, with diverse genders, races and ethnicities, and 48% were unemployed. Approximately 70% of these patients were polysubstance users. Initial assessments revealed low quality of life scores, and a mean Adverse Childhood Experiences score of 4.98. Following evidence-based interventions, there were significant improvements in depression severity (PHQ-9 scores, p=0.044) and reductions in drug and alcohol use severity (ASSIST scores, p< 0.05).

Fourteen medical students participating in the I-COPE program at the G-SAFE clinic reported gaining valuable insights into interprofessional care and the impact of social determinants of health. An anonymous survey showed 100% of the students agreed (25%) or strongly agreed (75%) that the course positively influenced their understanding and advocacy for persons with SUDs. Additionally, another 11 students took our new Addiction Medicine student elective, with 9 rating the teaching quality as excellent and recommending the elective to peers. Beyond I-COPE students, all third-year students also receive a 1.5-hour lecture on Addiction Medicine during their Internal Medicine clerkship.

This academic year, the SUD program became mandatory for 29 Internal Medicine and 13 Family Medicine interns, offering a structured curriculum and clinical experience previously unavailable. Interns attended one half-day clinic per week (four total), completed virtual and in-person community experiences, and submitted reflections which are pending analysis. A six-part 1-hour noon conference lecture series on Addiction Medicine was completed for all Internal Medicine residents. Additionally, one PGY-2 resident completed our new Addiction Medicine elective.

Conclusion & Discussion: The G-SAFE clinic and its interprofessional education model have successfully addressed critical gaps in SUD treatment and education at our academic medical center. By engaging underserved populations, particularly uninsured and unhoused individuals, the clinic achieved significant improvements in patient outcomes, including reduced depression and substance use severity. The I-COPE model enriched medical education by providing students with valuable insights into interprofessional care and the social determinants of health, as evidenced by positive feedback and high recommendation rates.

This initiative underscores the potential of integrating interprofessional education and community engagement to enhance patient care and educational experiences. The mandatory SUD curriculum for Internal and Family medicine interns further expands the program’s impact, preparing future healthcare professionals to effectively address SUD care.

Limitations such as scheduling challenges and reliance on only qualitative reflections and feedback highlight areas for improvement. Future efforts should focus on refining educational integration, including more validated quantitative assessments for evaluating educational curricula and expanding partnerships to ensure sustainability. Overall, the G-SAFE clinic and I-COPE model offer a replicable framework for addressing SUDs through innovative, collaborative approaches, setting a precedent for similar initiatives in other institutions.

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