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Related Experiment Video

Updated: Sep 22, 2025

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Lessons Learned in Implementing a Chronic Opioid Therapy Management System.

Narath Carlile, Theresa E Fuller¹, James C Benneyan¹

¹Healthcare Systems Engineering Institute, Northeastern University, Boston, Massachusetts.

Journal of Patient Safety

|May 26, 2022

Summary

This summary is machine-generated.

Implementing a risk-based workflow improved safe opioid prescribing in primary care. While challenges like team structure and evolving regulations persist, this approach offers a adaptable model for chronic opioid therapy management.

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Area of Science:

Health Services Research
Systems Engineering
Primary Care Medicine

Background:

Opioid misuse is a significant public health crisis in the US, causing substantial morbidity and mortality.
Safer management of chronic opioid therapy presents a critical challenge within primary care settings.
Existing primary care workflows often lack structured processes for safe opioid management.

Purpose of the Study:

To describe a collaborative effort between health services researchers, systems engineers, and clinicians to enhance chronic opioid therapy management.
To present the implementation results and lessons learned from a novel intervention toolkit for safer opioid use in primary care.
To offer a adaptable, risk-based workflow model for managing patients on chronic opioid therapy.

Main Methods:

Utilized iterative improvement lifecycles and systems engineering principles to develop a risk-based workflow model.
Identified and tracked key process metrics: patient opioid treatment agreements and urine drug tests.
Employed thematic analysis of focus group data to identify implementation barriers and lessons learned.

Main Results:

Initial surveys indicated a deficit in clinician and patient knowledge of available resources for opioid management.
A significant proportion of clinicians (69%) reported inheriting chronic opioid therapy patients rather than initiating them.
Process measures showed improvement over a 4-year period for 68 tracked patients, though full adherence was not universally achieved.

Conclusions:

Safe primary care opioid prescribing necessitates continuous monitoring and adaptive management strategies.
A risk-based approach to chronic opioid therapy is feasible but requires organizational adaptability and built-in redundancies.
Implementation barriers included team dynamics, the evolving opioid landscape, surveillance difficulties, and external disruptions like the COVID-19 pandemic.