The following resources can help clinics implement each of the Six Building Blocks to improving opioid management.

Leadership & Consensus resources

Opioid harm stories: Stories are the emotional drivers for engaging clinicians. Here are some personal stories of the harm caused by opioids.

Six Building Blocks self-assessment: A tool that can be used to measure status in the Six Building Blocks, both as a small group activity during site visits and by the Opioid Improvement Team to track progress over time.

Clinical education opportunities: This resource lists clinical education opportunities on opioids and chronic pain by topic.

CDC training and webinarsThe CDC has an interactive clinical training series and a webinar series available to the public.

UW TelePain: A clinical education resource.

Motivating slow to adopt providersSpecific strategies for encouraging providers to adopt the practices in the revised policies.

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

Chronic Pain Management TeamsThis resource supports the development of a Chronic Pain Management Team.

Policy, Patient Agreement, & Workflow resources

Model policy: An example policy your clinic can use during the policy revision process; developed using the CDC guidelines and Washington state opioid prescribing rules.

Policy checklist: A checklist to use when reviewing if your policy aligns with evidence-based guidelines.

CDC Guidelines for Prescribing Opioids for Chronic Pain

AMDG 2015 Interagency Guideline on Prescribing Opioids for Pain

Model patient agreement: An example patient agreement your clinic can use during the patient agreement revision process.

VA Opioid Taper Decision Tool: The Opioid Taper Decision Tool is designed to assist Primary Care providers in determining if an opioid taper is necessary for a specific patient, in performing the taper, and in providing follow-up and support during the taper.

Chronic pain appointment workflow: An example workflow for chronic pain appointments.

Opioid refill workflowAn example workflow for processing opioid refill requests.

Opioid list manager workflowAn example workflow for tracking and monitoring patients on long-term opioid therapy.

Rollout and training: A resource to think through how to do rollout and training on new approaches.

Tracking & Monitoring Patient Care resources

Morphine Equivalent Dose (MED) calculator

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

Purposes of tracking & monitoring: An outline of the key uses of data in tracking & monitoring patients on long-term opioid therapy to use when planning your approach.

Data to consider tracking: A list of variables to consider tracking and monitoring for care planning and measuring success.

Tracking & Monitoring example spreadsheet: An Excel spreadsheet a clinic can adapt to track and monitor key measures overall and by provider if they are unable to easily pull reports from their EMR.

List of opioid names: A list of opioids to use in identifying patients on long-term opioid therapy.

List of sedative names: A list of sedatives to use in identifying patients on concurrent sedatives and opioids.

Event tally: A form to help a clinic track a simple measure of interest over a couple weeks.

Planned, Patient-Centered Visits resources

Patient education:

Education resources for patients with chronic pain: A list of patient education materials relevant to patients with chronic pain, including resources about opioids, benzodiazepines, chronic pain, overdose, stigma, and pain self-management. 

CDC patient education example: A handout for patients educating them on the risks of long-term use of opioids.

Patient letter: A letter introducing patients to the clinic’s new approach to caring for patients on long-term opioid therapy.

WA DOH chronic pain patient notification: A handout for patients educating them on the risks of long-term use of opioids, disposal, and safe storage.

WA DOH acute pain patient notificationA handout for patients educating them on the risks of acute use of opioids, disposal, and safe storage.

Difficult conversations:

Provider guide to difficult conversations: Key principles and specific scripts to help providers navigate difficult conversations.

Staff guide to difficult conversations: Suggested conversation approaches and scripts for clinical and administrative staff who interact with patients on long-term opioid therapy.

Difficult Conversations video vignette: An example that illustrates using principles of how to have a difficult tapering conversation with a patient.

Empathic communication resourcesA list of empathic communication and motivational interviewing resources.

Planning for visits:

Turn the Tide pocket guide for cliniciansA quick reference for clinicians about opioid prescribing.

Pain Tracker: An example guide of assessments to use during visits about chronic pain.

Suggested opioid management scheduleA table outlining suggested tools and timelines for opioid management assessments.

Alternative treatments fact sheet: CDC recommended non-opioid treatments for chronic pain.

Evidence on complementary and alternative approaches to chronic painA summary of existing evidence for noninvasive non-pharmacological treatments and complementary health approaches for chronic pain conditions.

Chronic pain self-management resources: A list of suggested resources for providers, care coordinators, and patients to use for chronic pain self-management.

Chronic pain care plan exampleA 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.

For specific assessment tools, such as the Opioid Risk Tool, see Recommended Assessment table.

The CDC offers many helpful clinical tools on their website.

Caring for Complex Patients resources

Tips for managing patients on legacy prescriptions: Suggestions for how to approach patients you have inherited from another clinician.

Risk stratification and opioid prescribing: Suggestions for how to screen for and vary care according to risk level.

Buprenorphine information from SAMHSA: Buprenorphine is used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates, such as pain relievers like morphine.

Naloxone information from SAMHSA: Naloxone is a medication to counter opioid overdose.

Measuring Success resources

Measuring success metrics: A list of potential aims to use to measure success

Prepare and Launch milestonesA tool to track progress in achieving Prepare and Launch stage milestones.

Design and Implement milestonesA tool to track progress in achieving milestones of improving opioid management through the Six Building Blocks Program.

DIY Run ChartA DIY Excel tool from the Safety Medical Home Initiative that you can use to track progress over time on a measure (e.g., up-to-date patient agreements).

Self-Service resources

The following are additional resources for clinics who are implementing the Six Building Blocks without a Practice Coach.

Commitment Presentation: A PowerPoint template for clinics to use when determining whether to commit to implementing the Six Building Blocks Program independently.

Kickoff Event Manual: A manual to help a QI Lead plan and host a Kickoff Event run by a clinic.

Kickoff Event PresentationA PowerPoint template for a Kickoff Event run by a clinic.

Kickoff Event SurveyA survey to give providers and staff during the Kickoff to assess burnout and areas for change.