The opioid crisis touches all sectors of America’s patient population — especially underserved patients like agricultural workers in rural areas. In Washington and Idaho, six rural health clinics representing over 20 sites are working to ensure their policies, workflow, and clinical visits are aligned and implemented to address the crisis that has swept the nation.

The Fall 2016 Migrant Clinician's Network newsletter, "streamline", features an interview with MacColl Director Dr. Michael Parchman speaking about the Team-Based Opioid Management Project.

The project approaches the problem in part through guided self-assessments and shared learning opportunities in which enrolled clinics receive support for implementing the Six Building Blocks for Safe, Team-based Opioid Prescribing in Primary Care. 

Six Building Blocks

  1. Leadership and consensus: Build organization-wide consensus to prioritize safe, more selective, and more cautious opioid prescribing.
  2. Use a registry to proactively manage patients: Implement pro-active population management before, during, and between clinic visits of all chronic opioid therapy patients to ensure that care is safe and appropriate and to measure results of chronic opioid therapy improvement activities.
  3. Revise policies and standard work: Revise and implement clinic policies and define standard work for health care team members to achieve safer opioid prescribing and chronic opioid therapy management in each clinical contact with chronic opioid therapy patients.
  4. Planned, patient-centered visits: Through planned visits, conduct proactive population management before, during, and between clinic visits of all patients on chronic opioid therapy to ensure that care is safe and appropriate. Support patient centered, empathic communication for chronic opioid therapy patient care.
  5. Caring for complex patients: Develop policies and resources to ensure that patients who become addicted to opioids, or who develop complex opioid dependence, are identified and provided with appropriate care, either in the care setting or by outside referral.
  6. Measuring success: Continuously monitor progress and improve with experience.


Read more about Team-based Opioid Management and the 6 building blocks.