A Change Management Case Study for Safe Opioid Prescribing and Opioid Use Disorder Treatment

Area of Science:

• Primary Care Medicine
• Addiction Medicine
• Health Systems Management

Background:

• Opioid prescribing practices significantly contribute to the opioid epidemic.
• Primary care physicians are major opioid prescribers, facing challenges in balancing safe prescribing with treating opioid use disorder (OUD).
• Office culture and systems can hinder family physicians from achieving dual goals of safe opioid prescribing and OUD treatment.

Purpose of the Study:

• To present a case study illustrating the achievement of safe opioid prescribing and OUD treatment within a family medicine clinic.
• To describe a 5-year process utilizing change management models to foster supportive cultural and structural elements.

Main Methods:

• Employed Lewin's Three-Step Change Theory and the McKinsey 7S Model of Change as a framework.
• Described a 5-year implementation process in a family medicine clinic serving an underserved, multicultural population.
• Focused on integrating cultural and structural changes to support safe opioid prescribing and OUD treatment.

Main Results:

• The deliberate application of change management theories led to significant improvements in clinic practices, personnel, skills, and infrastructure.
• These changes have resulted in a stable and sustainable clinic culture.
• The clinic successfully integrated safe opioid prescribing and OUD treatment into its standard operations.

Conclusions:

• Lewin's and McKinsey's change management models offer valuable guidance for establishing and sustaining office-wide support.
• These models facilitate the creation of a culture and structure necessary to meet the dual objectives of safe opioid prescribing and OUD treatment.
• Implementing these frameworks can help family physicians effectively address the opioid crisis within their practices.