Objectives of this workgroup include:
- To commit to reviewing opioid prescribing practices within each participating practice
- To review, understand, and adapt several tools already available toward improving opioid prescribing practices (e.g. the CDC Opioid Prescribing Guidelines for Chronic Pain, opioid risk assessment tools/methods, opioid treatment agreement, monitoring and follow up with patients)
- To implement an opioid prescribing protocol in each participating practice and encourage clinicians to “take the pledge”
- To share resources and learn from each other (see Appendix B for links to relevant resources), including sharing of stories within VCSQI and TCPi.
TED Talk Worth Watching: The Agony of Opioid Withdrawal and What Doctors Should Tell Patients About It
This workgroup discussion reviews survey results of practices which prescribe opioids and recommendations for actions to take to address the opioid misuse epidemic.
Recording of Workgroup Call:
Discussion of Use of Patient & Provider Opioid Agreements/Contracts
View 3 presentations from VCSQI Meeting in Richmond, Va.
March 15 – Regulations & Guidelines; Use of Risk Tool; How to Have the Difficult Conversation with a Patient
From Practice to Regulation and Back Again
Presented by Barbara Allison-Bryan, MD, Virginia Department of Health Professions, and Marc Huntoon, MD, Virginia Commonwealth University Professor of Anesthesiology and Pain Management Specialist at VCSQI March 15, 2018 Quarterly Meeting in Richmond, Va. Includes Virginia’s national leadership efforts to impact prescribing practices and evidence-based pain management practices including “Use of Risk Tool in Assessment” and “How to Have the Difficult Conversation with a Patient.”
- There and Back Again- An Opioid Tale
- Opioid Regulations DHP
- OMW- 03-22-2018-Minutes-
- TCPI Opioid story template
- YouTube Recording of Workgroup Call
February 22 Workgroup – CDC Prescribing Guidelines; Cardiovascular Surgery Practice Steps to Create Guidelines
The VCSQI SAN 2.0 Opioid Workgroup reviewed CDC’s Guidelines for Opioid Prescribing for Chronic Non-Cancer pain and how these recommendations may assist you with establishing your own guidelines for other types of patients. Twelve recommendations are outlined, categorized into three major topics: when to prescribe opioids, how to prescribe opioids, and assessing the patient’s risk when using opioids.
Recommendation 6 may be particularly relevant to prescribers treating acute pain:
Long-term opioid use often begins with treatment of acute pain. When opioids are used for acute pain, clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. Three days or less will often be sufficient; more than seven days will rarely be needed.
Steve Dickson, CEO for Cardiovascular Surgeons, PA, Orlando, Fla. shares how their practice is working to standardize opioid prescribing practices among their clinicians. Ivan Berkel and Eddie Fonner recently made a site visit there to help them in this process. This discussion may help you begin to take your own steps for addressing this critically important care process.
Steve Dickson, CEO, Cardiovascular Surgeons, PA, explains efforts to standardize prescribing among 12 surgeons and other clinicians in their practice in Orlando, Florida.
Links to Resources:
- CDC Chronic Pain Prescribing Guidelines
- Take the Pledge to Help Address Opioid Misuse
- OMW- 02-22-2018-Minutes