Implementation of a Quality Improvement Learning Collaborative to Support Implementation of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain: Case Study from Nurse-Led Clinics

Abstract

Purpose

The authors describe a case study of a quality improvement initiative to implement the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain² (“2016 CDC Guideline”) into nurse-led primary care practices in central Appalachia.

Design

In this controlled pre–post quality improvement study, a policy change, an electronic health record form, and supporting education were implemented. Knowledge change and quality improvement metrics were measured before and after implementation.

Data Sources

The data comprised pre- and post-knowledge survey and quality improvement metrics from the electronic health record.

Results

After the implementation of the chronic pain intake form and supporting training and education, marked improvements in documentation and completion of the 2016 CDC Guideline and Tennessee Clinical Practice Guideline-concordant activities were observed, suggesting an increase in compliance with guidelines.

Conclusions

Quality improvement efforts that focus on opioid management best practices may be effective at enhancing 2016 CDC Guideline-concordant care in clinics, including nurse-led ones. Similar strategies could be trialed to ensure the 2022 CDC Clinical Practice Guideline recommendations for opioid and pain management are adopted effectively.

Practice Implications

Interventions to improve opioid and pain management through quality improvement efforts require policy changes, clinician and patient education, and electronic record tools.