Managing the Nation's Pain: NQF Issues Essential Guidance on Opioid Stewardship
The opioid epidemic in America is an urgent public health crisis with devastating consequences. According to the U.S. Centers for Disease Control and Prevention (CDC), nearly two million Americans have a prescription-related opioid use disorder (OUD) and more than 46 Americans die each day from a prescription opioid-related overdose—a more than four-fold increase since 1999. These staggering statistics demand coordinated commitment from healthcare organizations and communities to improve opioid stewardship, so that patients can be assured safe and effective pain management that reduces their risk of OUD and overdose.
The National Quality Forum’s (NQF) National Quality Partners™ (NQP™) galvanized NQF member organizations and other key public- and private-sector healthcare stakeholders to turn the tide on this national priority. The result is an essential guide, the National Quality Partners Playbook™: Opioid Stewardship, that supports healthcare organizations and clinicians across care settings and specialties of care in safely managing patients’ pain.
“The NQP Playbook provides a blueprint to help address the nation’s devastating opioid epidemic,” said Shantanu Agrawal, MD, MPhil, president and CEO of NQF. “It is a critically important tool for our nation’s frontline clinicians as they consider pain management strategies with patients.”
“This work will help the medical community start to shift direction in terms of the ways well-intended pain treatments affect our patients, families, clinicians and communities,” said Paul Conlon, PharmD, JD, senior vice president, Chief Quality & Patient Safety, for Trinity Health and co-chair of the NQP Opioid Stewardship Action Team. “It is an important step that will help us establish urgency around developing a comprehensive program for better pain treatment—one that will lead to sustainable approaches to preventing and mitigating against our current national substance abuse emergency.”
The NQP Playbook identifies fundamental actions to support high-quality, sustainable opioid stewardship, including:
- promoting healthcare leadership commitment and implementation of organizational policies that support opioid stewardship;
- advancing clinical knowledge, expertise, and practice in pain management and opioid prescribing guidelines;
- educating patients and family caregivers about the risks and benefits of pain management strategies, especially the use of opioids;
- tracking, monitoring, and reporting performance data on opioid stewardship, patient-related outcomes, and other pain management approaches;
- establishing accountability for promoting, establishing, and maintaining a culture of opioid stewardship; and
- supporting community collaboration to achieve maximum impact.
The NQP Playbook includes concrete examples and tactics for implementation, identifies barriers and suggested solutions, and connects clinicians to important tools and resources that are applicable across care settings. Implementation examples are organized into basic, intermediate, and advanced to allow organizations with varying levels of resources and expertise to identify opportunities for action. The intent is for organizations to determine which approach best fits their individual efforts and community needs.
The NQP Playbook encourages healthcare organizations to develop realistic measurement strategies to assess key areas such as clinician prescribing patterns, adherence to best practices, and the use of non-pharmacologic pain management options. In addition, the NQP Playbook identifies important drivers of change that can impact and advance opioid stewardship—including licensure, education, accreditation, payment, reimbursement, workforce management, and the use and integration of prescription drug monitoring programs into electronic health records—and urges federal entities, accreditation agencies, and partners in quality improvement to support action in these areas.
NQF developed the NQP Playbook with input from the NQP Opioid Stewardship Action Team, whose members served as technical consultants and contributors. The more than 40 public- and private-sector experts and national stakeholders who served on the Action Team include patient partners, clinicians, healthcare organizations, pharmacists, pain management experts, community-based organizations, and federal agencies.
The NQP Playbook: Opioid Stewardship is now available for download. A summary of the guide is available on NQF's website. NQF will host a fully accredited, one-day workshop on May 1, 2018 for clinicians and healthcare quality leaders to learn about implementing the NQP Playbook.
On March 12, NQF also released a new guide to improve shared decision making between patients and clinicians. The NQP Playbook™: Shared Decision Making in Healthcare offers vital guidance for communication between clinicians and patients as they work together to make healthcare decisions, including strategies to manage pain.