The following resources support the Practice Facilitator through helping clinics implement opioid management improvements using the Six Building Blocks. The Prepare & Launch Workbook, Design & Implement Workbook, and Monitor & Sustain Workbook walk the Practice Facilitator through the steps of each implementation stage.

Overarching resources

Six Building Blocks published articles:

Primary Care Clinic Re-Design for Prescription Opioid Management: Published in the Journal of the American Board of Family Medicine in 2017.

Team-Based Clinic Redesign of Opioid Medication Management in Primary Care: Effect on Opioid Prescribing: Published in the Annals of Family Medicine in 2019.

Staff and Clinician Work-Life Perceptions after Implementing Systems-Based Improvements to Opioid Management: Published in the Journal of the American Board of Family Medicine in 2019.

Barriers and Facilitators to Implementing Changes in Opioid Prescribing in Rural Primary Care Clinics: Published in the Journal of Clinical and Translational Science in 2020.

 

Preparing to be a Six Building Blocks Practice Facilitator:

Introductory materialsA list of introductory materials for beginning to learn about the Six Building Blocks and opioid management.

Description of the Practice Facilitator roleAn article with a clear description of the Practice Facilitator/Coach role.

The Six Building Blocks Clinical Advisor: A resource to support a Practice Facilitator in identifying and building a relationship with a Clinical Advisor who can help with the facilitation work.

Quality improvement resources: A list of places to get quality improvement training.

Six Building Blocks Practice Facilitator Training, Learning Module 1: Understanding the Basics of Chronic Pain and the Washington State Opioid Prescribing Rules.

Six Building Blocks Practice Facilitator Training, Learning Module 2: How a Practice Facilitator Can Overcome Barriers and Support Primary Care Clinic Efforts to Improve Chronic Pain Management.

Six Building Blocks Practice Facilitator Training, Learning Module 3: Providing Support to an Opioid QI Team in a Clinic.

Six Building Blocks Practice Facilitator Training, Learning Module 4: Engaging Clinicians and Staff in the Process of De-implementing Opioids for Chronic Non-Cancer Pain.

Six Building Blocks Practice Facilitator Training, Learning Module 5: What is a Stakeholder Assessment and Why is it Important?

 

Resources to use while coaching clinics:

Practice Facilitator Multi-site Log: A tool to track progress at multiple sites.

Levers of motivation guide: Ways to motivate providers and staff.

Common obstacles clinics face & potential solutions: A detailing of common obstacles that can arise when implementing opioid management improvements and solutions other organizations have used to overcome those obstacles.

Prepare & Launch stage resources

The objectives of this stage are to orient the Opioid Improvement Team and the clinic to the Six Building Blocks, prepare for the work ahead by assessing baseline status, and launch the program. This stage includes a leadership commitment meeting, two Opioid Improvement Team meetings, and a Kickoff Event with all clinicians and staff.

Prepare & Launch WorkbookThis workbook guides the Practice Facilitator through the steps of the Prepare & Launch Stage.

Pre-meeting worksheets (1&2)A list of activities to complete ahead of the Prepare & Launch meetings to assess baseline status.

Partnership Commitment Letter: An understanding of each organization’s role.

Building an opioid improvement teamInformation about who should be on an opioid improvement team to lead opioid management quality improvements.

Approaches to identifying patients: Suggested approaches to suggest clinics try when first attempting to identify their patients on long-term opioid therapy.

PowerPoint Presentations: Commitment/Introduction, Kickoff: PPTs to use during meetings.

Kickoff manualA guide to organizing the clinic-wide kickoff.

Kickoff survey: A survey to collect data before and after implementation of the Six Building Blocks program in order to set priorities for improvements and track changes over time.

Introduction to the Six Building Blocks Program: A short introduction to the Six Building Blocks Program and support options.

Introduction to the Six Building Blocks websiteA one-page introduction to the resources on the Six Building Blocks Website to give clinics.

Design & Implement stage resources

The objectives of this stage are to help the Opioid Improvement Team create and execute action plans to design and implement an improved approach to opioid management. This stage includes action plan development meetings with the Opioid Improvement Team every 3 months, monthly Shared Learning Calls between Opioid Improvement Teams at participating sites, and connection to clinical education for clinicians and staff.

Design & Implement WorkbookThis workbook guides the Practice Facilitator through the steps of the Design & Implement Stage.

Action Plan GuideThis document includes an introduction to using Action Plans to implement Six Building Blocks Milestones, Action Plan templates, and an Action Plan example.

Shared Learning Call Instructions: Instructions on conducting the Shared Learning Calls, including preparation, topics, tips, and a sample agenda.

Tips for achieving the Six Building Blocks milestones: This document shares tips and resources for achieving the Six Building Blocks milestones, along with solutions for common obstacles.

AHRQ Practice Facilitation Module: Mapping and Redesigning WorkflowAn educational guide to using mapping to help organizations redesign workflows.

Measuring outcomes survey: A survey to give Opioid Improvement Teams at the beginning and end of coaching support to assess progress over time.

Monitor & Sustain stage resources

The objectives of this stage are to review accomplishments and help the site make plans to overcome current challenges and move forward independently. This stage includes a final Opioid Improvement Team meeting and a close-out site visit.

Monitor and Sustain WorkbookThis workbook guides the Practice Facilitator through the Steps of the Monitor & Sustain Stage.

Success and Sustainability meeting slidesThese slides are an example outline of how to host a meeting with the Opioid Improvement Team to celebrate successes and make a sustainability plan.

Sustainability handoutThis handout outlines things to consider when making a sustainability plan for opioid management improvement work.

Monitor and Sustain activitiesThis handout outlines potential activities a site might want to engage in when they are slowing down in implementing opioid management improvement changes in order to monitor and sustain their improvements.

Measuring outcomes survey: A survey to assess measures at the start and end of practice transformation work.

Final Shared Learning Call agenda: A PowerPoint template for the final site visit