Building Block #3

Identify the patient population and develop ways to track progress

The patient population includes all patients receiving opioids. As the goals include pain management, both acute and chronic, organizations will consider whether to include, for example, chronic pain patients who may not be receiving opioids, but who would benefit by being included in the process improvement initiative. It may be helpful to identify high risk, complex patients within this population for more urgent action and more frequent monitoring. Each organization will determine the most efficient way to monitor this population given the tools and staff skills available.

Identifying and Tracking Patients on Opioids 1234 Describe briefly what your clinic is currently doing.
The clinic has a registry it uses to identify and track all patients on opioids. The registry is an updated list of patients taking opioids, as well as other items useful in managing their care. Clinics determine what should go on the registry, which usually includes the following: MED, opioid risk score, sedative co-prescribing, tapering status, and functional status. This information is reviewed monthly or quarterly by leadership and other prescribers to monitor progress towards treatment goals.
Risk Stratification for Complex Patients 1234 Describe briefly what your clinic is currently doing.
All patients identified as high risk, complex pain patients (see BB #5) are reviewed monthly, by PCP, care team and clinic leadership to ensure progress towards goals and patient safety.

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