COVID-19 and practice transformation: Building an office-based opioid treatment program in a family medicine residency practice.

INTRODUCTION: This brief report describes how a family medicine residency practice (FMRP) leveraged a resident-led quality improvement project and a grant-funded Addiction Integrated Care Team (AICT) to initiate an office-based opioid treatment (OBOT) program to provide medications for opioid use disorder during the COVID-19 pandemic. METHOD: In 2020, the practice experienced four disruptors that shifted motivation for practice development: (a) The COVID-19 pandemic demanded rapid change in primary care processes/staffing, including pivoting to telehealth/remote practice. (b) The practice's transition to a federally qualified community health center model meant a shift in organizational priorities that required offering OBOT services. (c) External grant resources became available through the AICT program to support practice core for OBOT, and 10 implementation strategies were utilized. (d) A resident champion implemented an OBOT quality improvement project. RESULTS: These efforts resulted in the practice offering the OBOT program and 18 patients receiving OBOT from January 2020 to February 2021, with 10 of 18 patients engaged for 12 months or longer. Further, the cumulative adoption and reach from January 2020 through September 2022 was 15 faculty and 14 residents becoming prescribers and 101 patients served within the OBOT program, respectively. DISCUSSION: FMRPs striving for significant practice transformation, such as implementing an OBOT program during a pandemic, may benefit from synergistic guidance and resources including established theory, strategies from the implementation science literature, and resident-led quality improvement efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Impact of Virtual Interviews on Recruitment and Implicit Bias.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic accelerated virtual residency interview adoption. The impact of virtual interviews on program directors' (PD) National Residency Matching Program (NRMP) Match satisfaction, their future interview plans, and their perceptions about virtual interviews' influence on bias are unknown. We report the results of a survey of family medicine (FM) PDs about these topics after mandatory virtual interviews in 2020-2021. METHODS: A national survey of all FM PDs was conducted in April 2021 (n=619). The response rate was 46.37% (n=287). Questions asked whether PDs conducted virtual interviews, as well as PDs' general perceptions of virtual interviews' impact on administrative burden, diversity and bias; PD's ability to communicate program culture and assess applicants' alignment with program values; PD's satisfaction with Match results; and plans for interview structure postpandemic. RESULTS: Two hundred forty-four (93.1%) respondents performed only virtual interviews; 83.9% (n=220) conducting virtual interviews were satisfied with Match results, with no difference between programs with all virtual interviews vs others (OR 1.2, P=.994). PDs who communicated program values and involved residents in virtual interviews experienced higher Match satisfaction (OR 7.6, P<.001; OR 4.21, P=.001). PDs concerned about virtual interviews increasing bias against minorities before 2020 were still concerned after (OR 8.81, P<.001) and had lower Match satisfaction (OR 0.24, P=.001). CONCLUSIONS: Most FM PDs conducted entirely virtual interviews in 2020 and were satisfied with the Match. Interview processes including residents and conveying residency culture increased Match satisfaction. PDs are concerned about bias in virtual interviews, but more investigation about bias is needed.