The investigative and focusing work done during the Prepare and 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 long-term opioid therapy using the Six Building Blocks. During this stage, clinics work to achieve the following milestones with the support of the Practice Facilitator using the Design & Implement Workbook, Shared Learning Calls with other sites, and clinical education.

Design & Implement Stage Milestones Checklist

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

Building Block Activities
Leadership & consensus

  • Protected time for improvement team to meet and work
  • Regularly emphasize project importance and solicit feedback during staff and clinician meetings
  • Clinical education opportunities offered to staff and clinicians, including on pain etiology
Policies, patient agreements, & workflows

  • Policies revised to align with evidence-based guidelines (e.g., CDC, AMDG)
  • Patient agreement revised to support the policy and educate patients about risks
  • Workflows written to support policies
  • Training conducted on policies, agreement, workflows, and supporting EHR templates
Tracking & monitoring patient care

  • Patients on long-term opioid therapy identified
  • All clinicians and delegates signed up for the prescription data monitoring program
  • Calculating MED as dose or medication changes is possible and easy for clinicians and staff
  • There is a dashboard of key measures for all patients on long-term opioid therapy
  • Data are used to monitor care gaps, high-risk patients, and clinical variation
Planned, patient-centered visits

Caring for complex patients

  • Tools are selected and in use to identify complex patients, such as those with behavioral health disorders or OUD
  • Clear referral pathways are in place for complex patient resources
Measuring success