Six Building Blocks Program
| Building Block and Description | Key Activities |
|---|---|
| Leadership and consensus | Clinical champion and team continually provide visible leadership |
| Demonstrate leadership support and build organization-wide consensus to prioritize more selective and cautious opioid prescribing. | Solicit and respond to feedback |
| Build organization-wide consensus | |
| Policies, agreements, and workflows | Revise and align policy and agreement in accordance to evidence, guidelines, and regulations |
| Revise, align, and implement clinic policies, patient agreements, and workflows for health care team members to improve opioid prescribing and care of patients with chronic pain. | Redesign workflows to support policy |
| Tracking and monitoring patient care | Develop tracking systems |
| Implementing pro-active population management before, during, and between clinic visits of all patients on long-term opioid therapy. | Track patient care in order to pro-actively manage patients |
| Planned, patient-centered visits | Train on and implement workflows |
| Prepare and plan for the clinic visits of all patients on long-term opioid therapy. Support patient-centered, empathic communication for care of patients on long-term opioid therapy. | Develop patient outreach and education |
| Train on patient-centered empathic communication | |
| Caring for complex patients | Identify assessment tools |
| Develop policies and resources to ensure that patients who develop opioid use disorder and/or who need mental/behavioral health resources are identified and provided with appropriate care, either in the care setting or by outside referral. | Identify and connect to resources |
| Measuring success | Identify aims and success metrics |
| Continuously monitor progress and improve with experience. | Measure success and continue improvements |
| Mechanisms of Support from the Six Building Blocks Facilitation Team | Description |
| Kickoff visit | Site visit where all members of the organization's clinics (clinicians, nurses, medical assistants, front desk staff) come together to discuss making improvements to opioid management |
| Clinic-wide learning about evidence and guidelines | |
| Small-group activity to self-assess current opioid management practices and to identify priorities for improvement | |
| Practice facilitation/coaching | Guidance in creating an opioid quality improvement team |
| Ongoing guidance to develop and implement action plans to make improvements to opioid management based on best practices | |
| Connection to tools and resources to support improvements (e.g., example policy, agreement, and workflows) | |
| Shared learning calls | Monthly virtual learning collaboratives between participating sites |
| Brainstorm ideas for overcoming existing challenges | |
| Share successful strategies and resources | |
| Clinical education | Twice-monthly virtual clinical education run by a clinician pain specialist |
| Didactic presentations on topics identified as important by the sites (e.g., functional assessment, addiction assessment;, exercise and pain) | |
| Presentations and discussions of difficult cases |