Revise, align, and implement clinic policies, patient agreements, and workflows for health care team members to improve opioid prescribing and care of chronic pain patients.

4. Policy development/revision 123 456 789 101112
Comprehensive policies* regarding chronic opioid therapy that reflect evidence-based guidelines, such as the CDC Guideline for Prescribing Opioids for Chronic Pain or state-based opioid prescribing guidelines… …do not exist. …exist, but have not been recently revised and updated. …exist, have been recently updated, but are still lacking essential components. …exist, and have been recently updated to reflect recent evidence-based guidelines, and are comprehensive.
5. Policy implementation 123 456 789 101112
Policies regarding chronic opioid therapy… …have not been distributed to clinicians and staff. …have been distributed to clinicians and staff, but have not been discussed. …have been distributed, have been discussed with all clinic staff and clinicians, but are not consistently followed. …have been distributed, have been discussed with all clinic staff and clinicians, and are consistently followed.
6. Patient agreements 123 456 789 101112
Formal signed patient agreements regarding chronic opioid therapy… …do not exist. …exist, but do not align with current clinic policies and/or are not consistently used …exist, align with current clinic policies, but are not consistently used. …exist, align with current policies, and are consistently used with all patients on chronic opioid therapy.
7. Workflows 123 456 789 101112
Clinic workflows for managing patients on chronic opioid therapy… …do not exist. …exist, but do not support current clinic policies. …exist, support current clinic policies, but are not fully implemented. …exist, support current clinic policies, and are fully implemented.

*Examples of areas that a comprehensive policy might address include:

  • Prescribing opioids for acute pain (CDC #6, #7)
  • Duration and dose of opioids for chronic pain (CDC #4, #5, #8)
  • Use of non-opioid and non-pharmacological therapies (CDC #1)
  • Co-prescribing of opioids and benzodiazepines (CDC #11)
  • Urine drug screening (CDC #10)
  • Monitoring of state controlled substances database (CDC #9)
  • Patient agreements (CDC #2)
  • Patient education (CDC #2, #3)
  • Tapering of opioids (CDC #5, #7)
  • Use of naloxone (CDC #8)
  • Use of buprenorphine (CDC #12)
  • Use of methadone (CDC #4, #7)