The investigative and focusing work done during the launch stage offers the opioid improvement team a picture of current practices, resources, and possibilities. Now it is time to put that foundational work to good use and help practices design and implement new approaches to care for patients on chronic opioid therapy using the Six Building Blocks. During this stage, clinics conduct the following recommended activities with the support of the Practice Coach, Shared Learning Calls with other sites, and clinical education.

Download Design & Implement Stage Activities Checklist

This is a starting list of activities for this stage, which you can adapt to your needs.

Building Block Activities
Leadership & consensus

  • Protect time for improvement team to meet
  • Emphasize project importance with updates at weekly & monthly staff meetings
  • Provide resources needed to support tracking and monitoring of COT patients and measures of success
  • Identify specific patients with early successes and share stories with clinicians and teams
  • Transparently share measures of success with clinicians and staff
  • Obtain feedback from staff and clinicians and respond
Policies, patient agreements, & workflows

  • Revise policies to align with evidence-based guidelines (e.g., CDC, AMDG)
  • Revise patient agreement to support revised policy and educate patients about risks
  • Discuss, obtain formal approval for, & distribute new policies
  • Create and implement a workflow to get patient agreements signed
  • Develop workflows that support your policies and guide staff
Tracking & monitoring patient care

Planned, patient-centered visits

Caring for complex patients

  • Select tools and how to use them for identifying complex patients, such as and those at high risk (e.g., PTSD, anxiety)
  • Identify and implement monitoring and support approaches for complex patients
  • Designate ways to identify risk level for pre-visit planning
  • Ensure clear referral pathways for complex patient resources and a system for closing the loop on referrals
  • Implement and iterate workflows to risk-stratify patients
Measuring success

  • Create plans to achieve goals
  • Develop consensus on measures of success and define how they will be measured
  • Regularly review measures of success data at the clinician level