Source | Unit of observation | Type | Domains/content | Frequency |
---|---|---|---|---|
Semi-structured staff interviews | QI leads, clinical champions, key staff involved in implementation | Qualitative | Adaptability, complexity, design quality and packaging, execution* Barriers and facilitators to implementation Adoption, acceptability, feasibility, appropriateness, sustainability** Lessons learned | At study startup, midway through, and end |
Call notes/emails | Health care organizations | Qualitative | Barriers and facilitators to implementation Adaptability, acceptability, feasibility** | Ongoing |
Practice documents | Health care organizations | Qualitative | Intermediate outcomes and care processes (6BBs): Opioid prescribing policies and procedures, clinical workflows, dashboards, patient registries, patient agreements, training and education offerings, opioid tracking and monitoring reports, care plan templates, patient educational materials, screening tools related to opioid management, referral processes between primary care and behavioral health and/or pain specialists | Ongoing |
Clinical staff survey | Clinical staff: primary care providers, behavioral health providers, nurses, social workers, medical assistants | Quantitative | Penetration** Engagement in implementation Prescribing self-efficacy (prescribers only) Burnout Adaptive reserve*** | At study startup and 12 months later |
6BBs Milestones worksheet | Health care organizations | Quantitative | Adoption and fidelity** | At study startup, midway through, and end |
Opioid quality improvement measures | Clinics within health care organizations | Quantitative | Effectiveness measures (CDC Guideline): • Proportion of patients on long-term opioid therapy prescribed ≥ 90 MMEs per day • Proportion of patients on long-term opioid therapy co-prescribed a benzodiazepine • Proportion of patients with a new opioid prescription for chronic pain with documentation that a prescription drug monitoring program was checked prior to prescribing • Proportion of patients with a new opioid prescription for chronic pain with documentation that a urine drug test was performed prior to prescribing | Quarterly for study duration |