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 |