Primary Care Outpatient Clinics

The Cabinet approached KHA to expand its bandwidth and provide education and guidance in opioid stewardship to primary care clinics. The suggested program, called Six Building Blocks (6BB), was created by a physician-led multidisciplinary team from the University of Washington Department of Family Medicine and the Kaiser Permanente Washington Health Research Institute. The 6BB Program is a team-based approach to improving opioid management in primary care. In its entirety, the 6BB Program is a 9-to-12-month commitment for primary care clinics. This program is a “clinic redesign” with goals to consistently treat chronic pain patients on long-term opioid therapy in accordance with evidence-based clinical practice guidelines.

For more information about the outpatient KYSOS program, contact Marilyn Connors and Shanna Jaggers.

Health care worker with patient
The Kentucky Hospital Association (KHA) partnered with UK HealthCare and the Cabinet for Health and Family Services as part of the Kentucky Opioid Response Effort (KORE) to launch the Kentucky Statewide Opioid Stewardship (KY SOS) program.
The KY SOS Program is working with Kentucky hospitals to fight the opioid epidemic.  The program provides services to inpatient, outpatient primary care clinics, and has just expanded its bandwidth to include emergency departments (ED) across the Commonwealth. Reducing opioid overprescribing while improving safe opioid use in inpatient and primary care clinics in Kentucky continues to be the KY SOS mainstay and goal. With the addition of the ED Bridge program, KY SOS now addresses the full continuum of care for Kentucky patients, treatment of pain and treating those with opioid use disorder (OUD).
The newest initiative within KY SOS is the launch of the Emergency Department (ED) Bridge Program.  The main objective of the ED Bridge Program is to ensure patients with OUD receive 24/7 access to care.  EDs have an incredible opportunity to make OUD treatment accessible to all.  
The state has 11 ED Bridge Programs in place, making a difference in the lives of patients and their communities.  The KY SOS team will continue to expand the ED Bridge Programs into acute care hospital EDs across the state.  
The KY SOS ED Bridge Program goal is to increase access to treatment and assist patients in their road to recovery, thus saving lives in Kentucky communities.

The Kentucky Hospital Association partnered with the Cabinet for Health and Family Services as part of the Kentucky Opioid Response Effort (KORE) to launch the Kentucky Statewide Opioid Stewardship (KYSOS) program. The goals of the KYSOS program are to decrease opioid overprescribing while improving safe opioid usage. As part of the effort to combat the state’s opioid epidemic, KYSOS offers an opioid stewardship program to provide education and guidance to hospital-owned primary care outpatient clinics. KHA and KYSOS plan to implement this program throughout the state.

  • Program purpose is to help primary care clinics implement a consistent, team-based, patient-centered approach for the care of patients on long-term opioid treatment for chronic pain
  • Created by a physician-led multidisciplinary team from the University of Washington Department of Family Medicine and Kaiser Permanente Washington Health Research Institute
  • Evidence-based quality improvement guide, built upon the CDC 2016 Clinical Guidelines for Opioid Prescribing
  • Participating outpatient primary care clinics engage in a 9-12 month commitment to work with the KYSOS outpatient team to improve opioid management
  • Achieved through development of an Opioid Improvement Team, an assessment of current policies, workflows and procedures, interviews with providers and key stakeholders, training through webinars and shared resources
  • Prioritizes each primary care clinics’ specific needs and develops an action plan
  • Monthly data submission to Kentucky Quality Counts required for all participating clinics

Six Building Blocks Program: A Team-Based Approach to Opioid Management in Primacy Care

  1. Leadership and consensus
  2. Policies, patient agreements, and workflows
  3. Tracking and monitoring patient care
  4. Planned, patient-centered visits
  5. Caring for complex patients
  6. Measuring success

Map of Kentucky Outpatient Program Sites

July 2024

Encyclopedia of Measures (Outpatient)

April 2023

Metrics for patients on long-term opioid therapy.


Outpatient Resources

TitleSummaryCategoriesTagsFile TypeLinkDatehf:doc_categorieshf:doc_tagshf:file_type
Important Information About Your Opioid Prescription One-Pager

This information is to help you better understand the risks and benefits of taking an opioid medication that is prescribed to you. It may also help you communicate better with your doctor or healthcare provider when discussing your pain management.

, , , pdfJune 13, 2024ed-bridge inpatient outpatient patient-resourcespdf
NIDA Initiating BUP Resources for Prescribers

Includes examples and cases for motivating patients (National Institute on Drug Abuse)

, , , wwwApril 9, 2024ed-bridge inpatient outpatient provider-resourceswww

If we want addiction destigmatized, we need a language that’s unified. The words we use matter. Caution needs to be taken, especially when the disorders concerned are heavily stigmatized as substance use disorders are.

, , , wwwApril 9, 2024ed-bridge inpatient outpatient provider-resourcestoolswww
KYSOS Webinar: Impact of OUD Stigma

, , , wwwMarch 28, 2024ed-bridge inpatient opioid-use-stigma outpatientwebinarwww
Opioid Overdose Recognition and Response: A Guide for Communities and Bystanders

Naloxone educational how-to and informational guide from the Department of Public Health

, , , pdfFebruary 2, 2024ed-bridge inpatient naloxone outpatientpdf
Substance Abuse and Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation.

wwwFebruary 1, 2024outpatientwebsitewww
KBML Considerations for Urine Drug Testing

The Board has developed the following intervals for urine drug screens in order to provide some guidance to physicians…

aspxFebruary 1, 2024outpatientaspx
Talking About Naloxone with Patients Prescribed Opioids

This guide offers tips to help clinicians communicate the benefits of naloxone to patients, family members, and caregivers. (CDC)

, , pdfFebruary 1, 2024naloxone outpatient provider-resources ed-bridgepdf
When to Offer Naloxone to Patients

Only 1 naloxone prescription is dispensed for every 70 high-dose opioid prescriptions. As a healthcare professional, you play a critical role in ensuring patients receive naloxone. (CDC)

, , pdfFebruary 1, 2024naloxone outpatient provider-resources ed-bridgeguidelinespdf
National Quality Forum Opioid Stewardship Playbook

The National Quality Partners™ (NQP) Opioid Stewardship Action Team brought together experts and recognized leaders from the private and public sectors committed to addressing the nation’s escalating opioid epidemic.

, , aspxFebruary 1, 2024inpatient outpatient provider-resourcesaspx
Michigan OPEN: Opioid Prescribing

OPEN takes a preventative approach to the opioid epidemic by focusing on appropriate opioid prescribing and pain management best practices in acute care settings (surgery, dentistry, emergency medicine, obstetrics, pediatrics).

, , wwwFebruary 1, 2024inpatient outpatient provider-resourcesguidelineswww
Kentucky Poison Control Information for Healthcare Professionals

Acetaminophen Overdose Faxable Guidelines, Recommendations RE Cetylev, Antidote Stocking Guide, Ethanol Dosing for Toxic Alcohol Ingestion, Synthetic Cannabinoids

, , wwwJanuary 31, 2024inpatient outpatient provider-resourcesguidelineswww
Comfort Menu

Alliant Quality

, , pdfJanuary 31, 2024inpatient outpatient provider-resourcespdf
CDC Patient Education

Pain can impact almost every aspect of your life, leading to limited physical functioning, poor mental health, and reduced quality of life. No matter the cause of your pain, you should receive access to safe and effective pain management options and good communication with your doctor to make informed decisions about what is right for you.

, htmlJanuary 31, 2024outpatient patient-resourceswebsitehtml
Voices of Hope

Mission Statement: To promote lifelong recovery from the chronic disease of addiction through recovery support services, advocacy, research and education.

, wwwJanuary 31, 2024outpatient patient-resourceswebsitewww
Operation Unite

Operation UNITE provides a toll-free Treatment Referral Line for anyone seeking assistance with a substance use disorder. 1-833-859-4357

, , wwwJanuary 31, 2024inpatient outpatient patient-resourceswww
Kentucky Naloxone Copay Program

Kentucky Pharmacists Association

, , wwwJanuary 31, 2024inpatient outpatient patient-resourceswebsitewww
Never Use Alone

Toll-free national overdose prevention, detection, life-saving crisis response and medical intervention services for people who use drugs while alone. Never Use Alone’s peer operators are available 24-hours a day, 7 days a week, 365 days a year. Call Never Use Alone 877-696-1996, your Overdose Prevention Lifeline.

, , wwwJanuary 31, 2024inpatient outpatient patient-resourceswebsitewww
Find Recovery Housing Now

The purpose of (FRHNKY) is to link individuals in recovery to safe, quality, and available recovery housing in Kentucky.

, , wwwJanuary 31, 2024inpatient outpatient patient-resourceswebsitewww
988 Suicide and Crisis Lifeline

When people call, text, or chat 988, they will be connected to trained counselors that are part of the existing Lifeline network. These trained counselors will listen, understand how their problems are affecting them, provide support, and connect them to resources if necessary.

, , wwwJanuary 31, 2024inpatient outpatient patient-resourceswebsitewww
Hope and Health KY

Individuals seeking treatment for themselves or others – as well as family members who have questions or are in need of support – can call 1-833-8KY-HELP (1-833-859-4357) toll-free or text HOPE to 96714 and speak with a specialist about available treatment services most relevant to their needs. All calls are confidential.

, , wwwJanuary 31, 2024inpatient outpatient patient-resourceswebsitewww

Enables patients and family members to find information about available substance use disorder treatment options in the Commonwealth of Kentucky.

, , , wwwJanuary 31, 2024ed-bridge inpatient outpatient patient-resourceswebsitewww
Any Positive Change: Harm Reduction is Public Health

, wwwNovember 9, 2023inpatient outpatientwebinarwww
2023 Naloxone Update

, , wwwSeptember 26, 2023inpatient naloxone outpatient ed-bridgewebinarwww
Integrating MAT/MOUD in Primary Care

, wwwSeptember 12, 2023inpatient outpatientwebinarwww
Starting from Strength: How the Trait-Based Model of Recovery is Changing Addiction Treatment

, wwwAugust 16, 2023inpatient outpatientwebinarwww
Treating Mental Health and Substance Use Disorder

, wwwJuly 26, 2023inpatient outpatientwebinarwww
ASAM DEA Education Requirement for Providers

American Society of Addiction Medicine

wwwJune 27, 2023outpatientwebsitewww
Nonopioid Therapies for Pain Management


, htmlJune 14, 2023outpatient provider-resourceshtml
Outpatient Encyclopedia of Measures

Primary Care and Outpatient Clinic

pdfApril 1, 2023outpatientpdf
CDC Clinical Practice Guideline at a Glance

Applying the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain

, , htmlMarch 16, 2023inpatient outpatient provider-resourcesguidelineshtml
Addiction Medicine Toolkit


, , htmlJanuary 31, 2023inpatient outpatient provider-resourcestoolshtml
Pain Management of an Ankle Sprain

, wwwJanuary 18, 2023inpatient outpatientwebinarwww
Clinical Practice Guideline for Prescribing Opioids for Pain


, , htmNovember 4, 2022inpatient outpatient provider-resourcesguidelineshtm
CDC Guidelines for Opioid Prescribing

This guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years.

, wwwNovember 4, 2022outpatient provider-resourcesguidelineswww
Unspoken Risks of Opioids

wwwSeptember 20, 2022outpatientwebinarwww
Empathy: Talking to Patients About Substance Use Disorder

As a clinician, you have an important role in screening patients for a substance use disorder and connecting them to treatment resources. You may also be actively involved in their treatment. (CDC)

, , htmlJuly 7, 2022inpatient outpatient provider-resourceshtml
BRAVO Opioid Tapering Protocol

Oregon Pain Guidance

, , wwwFebruary 1, 2022inpatient outpatient provider-resourceswww
Linking People with Opioid Use Disorder to Medication Treatment

A Resource for Action of Policy, Programs, and Practices (CDC)

, , January 1, 2022inpatient outpatient provider-resources
Safe Opioid Disposal – Remove the Risk Outreach Toolkit

FDA outreach toolkit to help education patients on safe, proper disposal of opioids

, , , wwwMarch 19, 2021inpatient outpatient provider-resourcespromotional-materials toolswww
Medication Risk Alert: Opioids & Benzodiazepines

Alliant Quality

, , pdfFebruary 3, 2021inpatient outpatient provider-resourcespdf
Words Matter: Terms to Use and Avoid When Talking About Addiction

This handout offers background information and tips for providers to keep in mind while using person-first language, as well as terms to avoid to reduce stigma and negative bias when discussing addiction.

, , pdfJanuary 13, 2021inpatient outpatient provider-resourcesguidelinespdf
KORE Deaf and Hard of Hearing Language Access Program Guidelines

Kentucky Opioid Response Effort

, pdfSeptember 1, 2020outpatient provider-resourcespdf
Kratom Drug Fact Sheet


, , pdfApril 1, 2020inpatient outpatient provider-resourcespdf
Medication-Assisted Treatment (MAT) for Opioid Use Disorder Printable Guide

A Printable Pocket Guide, created in partnership with AHCCCS and the ASU Medical Advisory Board

, , pdfJuly 3, 2019inpatient outpatient provider-resourcesguidelinespdf
HHS Pain Management Best Practices

Updates, Gaps, Inconsistencies, and Recommendations

, , pdfMay 9, 2019inpatient outpatient provider-resourcespdf
Kratom Drug Facts

NIH National Institute on Drug Abuse

, , pdfApril 1, 2019inpatient outpatient provider-resourcespdf
What’s Trending? Kratom


, , pdfJanuary 1, 2018inpatient outpatient provider-resourcespdf
Beyond Opioids: How Physical Therapy Can Transform Pain Management and Improve Health

APTA White Paper

, , pdfJanuary 1, 2018inpatient outpatient provider-resourcespdf
Prescribing and Administering Opioid Doses Based Solely on Pain Intensity

American Society for Pain Management Nursing Position Statement

, , pdfJune 1, 2016inpatient outpatient provider-resourcespdf