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 chronic long-term therapy.

Instructions: First, review each question and circle the description that best reflects your organization’s current status. Then, select the number that best reflects where you are within that description. There are three number options for each answer to allow you to select how far along you are. The higher the number, the further along you are in that domain. A PDF of this section of the assessment is here.

11. Planned opioid patient visits 123 456 789 101112
Before routine clinic visits, patients on long-term opioid therapy… …are not identified. There is no advance preparation for patient visits for long-term opioid therapy. …are sometimes identified, but there is no discussion or advance preparation for visits with patients prescribed long-term opioids. …are identified, and a discussion or chart review to prepare for the visit sometimes occurs. …are consistently identified and discussed before the visit. The chart is reviewed and preparations made to address safe opioid use.
12. Empathic communication 123 456 789 101112
Training on patient-centered, empathic communication emphasizing patient safety, e.g., opioid risks, dose escalation, and to tapering… …has not been offered to clinicians and staff. …has been offered to clinicians and staff, but there was limited participation. …has been offered and the majority of clinicians and staff participated. …is consistently offered with widespread, regular participation.
13. Patient involvement 123 456 789 101112
Training on how to involve patients on long-term opioid therapy in decision-making, setting goals for improvement and providing support for self-management… …has not been offered to clinicians and staff. …has been offered to clinicians and staff, but there was limited participation. …has been offered and the majority of clinicians and staff participated. …is consistently offered with widespread, regular participation.
14. Care plans 123 456 789 101112
Chronic care plan* templates for chronic pain management… …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.
15. Patient education 123 456 789 101112
Patient education materials that include explanation of the risks, and limited benefits of long-term opioid use… …do not exist. …exist, but strategies to disseminate to patients do not exist. …exist and dissemination strategies exist, but the strategies have not been fully implemented. …exist, dissemination strategies exist, and the strategies have been fully implemented.

* A chronic pain care plan is a tailored set of written steps and key information that a provider and patient agree will be used to manage the patient’s pain. It can include: goals (e.g., functional activities), current or planned treatments (e.g., physical activity prescription, medications), and a timeframe for reevaluation (e.g., follow-up in 3 months).