How Hands-On Pain Skills Intensive Trainings Complement ECHO Pain and Opioid Management Programs: A Program Evaluation with the Indian Health Service

Abstract

Objective To evaluate the impact of Pain Skills Intensive trainings (PSIs) as a complement to the Indian Health Service (IHS) and the Chronic Pain and Opioid Management TeleECHO Program (ECHO Pain) collaboration. Design On-site PSIs conducted over two to three days were added to complement ECHO Pain at various IHS areas to enhance pain skills proficiency among primary care teams and to expand the reach of ECHO collaboration to ECHO nonparticipants. Setting This evaluation focuses on two PSI trainings offered to IHS clinicians in Albuquerque, New Mexico, and Spokane, Washington, in 2017. Methods The mixed-methods design comprises CME surveys and focus groups at the end of training and 12 to 18 months later. Quality of training and perceived competence were evaluated. Results Thirty-eight participants attended the two PSI workshops. All provided CME survey results, and 28 consented to use of their postsession focus group results. Nine clinicians participated in the virtual follow-up focus groups. IHS clinicians rated the PSIs highly, noting their hands-on and interdisciplinary nature. They reported above-average confidence in their skills. Follow-up focus groups indicated they were pursuing expanded options for their patients, consulting other clinicians, serving as pain consultants to their peers, and changing prescribing practices clinic-wide. However, rurality significantly limits access to ancillary and complementary services for many. Clinicians reported the need for additional training in integrating behavioral health into their practice. Conclusions Hands-on pain skills and information on medication-assisted treatment (MAT) are critical to the successful treatment of chronic pain and opioid use disorder. The PSIs provide clinicians with critical competencies in assessment and screening, pain management, and communication skills, complementing required IHS training and telementoring from ECHO Pain.

Measuring the Success of a Project ECHO Implementation: Results from an International e-Delphi Study

“…Telementoring provides a platform for professionals with specific content knowledge and expertise within a particular organisation/context to collaborate, share and empower colleagues internally and externally (Agley et al, 2021 ; Bachynsky, 2020 ; Barbera et al, 2017 ; Christian & Andreas, 2019 ; Gegenfurtner & Ebner, 2019 ; Hauer & Quill, 2011 ). The virtual nature of telementoring overcomes traditional boundaries of geography, sector, professional discipline and seniority, and other siloes to integrate the way workforces can learn, seek advice and support, and consequently use newly acquired knowledge to enhance their service provision capabilities (Arora et al, 2020 ; De Witt Jansen et al, 2018 ; Gleason et al, 2020 ; Joshi et al, 2020 ; Katzman et al, 2020 , 2021a , 2021b ; Lewiecki et al, 2017 ; McPhillips et al, 2021 ; Nhung et al, 2021 ; Tosi et al, 2020 ). While telementoring is not a new concept, the contemporary implementation of telementoring models such as Project ECHO is a disruptive innovation which effects change within the organisation adopting the model for the first time.…”