The opioid crisis impacts communities in every pocket of our country, and delivery systems are increasingly seeking ways of interacting with patients on long-term opioids to ensure their safety.  As a result, it’s more important than ever to find effective ways to systematically support and care for those who work in primary care providers because they’re often one of the first points of contact for many patients on opioid therapy.

MacColl senior scientist Dr. Michael Parchman and colleagues at the University of Washington have turned their attention to the critical task of finding ways to ease the burden of primary care providers who care for patients on long-term opioid therapy for non-cancer pain.  

Michael and his team have developed and tested the 6 Building Blocks, an innovative program to provide small rural clinics with practice support to reduce patients’ use of opioids.  The program is comprised of six common elements for team-based redesign of opioid medication management in smaller primary care settings:

  1. Provide supportive leadership and build consensus;
  2. Revise, align, and implement clinic policies, patient agreements, and workflows;
  3. Track and monitor patient care;
  4. Prepare for planned, patient-centered visits;
  5. Develop resources for “complex” patients with more needs; and
  6. Measure and celebrate success.

One of the results of testing the 6 Building Blocks is the finding that it improved work-life experience for clinicians and staff in participating clinics. 

Staff and Clinician Work-Life Perceptions after Implementing Systems-Based Improvements to Opioid Management”, published in September’s Journal of the American Board of Family Medicine, reports that that in addition to significant declines in both the proportion of patients on high-dose opioids and the total number of patients receiving opioids, the clinics that implemented specific system-based improvements also saw improved clinician and staff perceptions of work-life quality.

Michael and his team implemented the Team-Based Opioid Management Study within 6 rural-serving primary care organizations, totaling 20 clinic members of the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region Practice and Research Network, a primary care practice-based research network in the 5-state Washington, Wyoming, Alaska, Montana, and Idaho region.

Each participating organization formed an opioid improvement team that included a clinician champion and quality improvement lead to implement the Six Building Blocks. Among others, clinical providers and staff described experiences in these areas:

  • Increased confidence and comfort in quality of care;
  • Increased confidence and comfort in their role;
  • Increased collaboration and teamwork;
  • Improved ability to respond to external administrative requests;
  • Positive shift in the relationship with the patient; and
  • Overall decrease in stress.

Two physicians in the WWAMI region share their experiences implementing this program on the University of Washington Institute of Translational Health Sciences blog.

 Access the full publication: "Staff and Clinician Work-Life Perceptions after Implementing Systems-Based Improvements to Opioid Management."