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.