• J Am Board Fam Med · Jan 2020

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

    • Randi Sokol, Zev Schuman-Olivier, Maren Batalden, Laura Sullivan, and Allen F Shaughnessy.
    • From Tufts University School of Medicine, Boston, MA (RS, AFS); Department of Psychiatry, Harvard Medical School, Boston, MA (ZS-O); Harvard Medical School, Boston, MA (MB); Malden Family Medicine Center, Cambridge Health Alliance, Malden, MA (LS, RS, AFS).
    • J Am Board Fam Med. 2020 Jan 1; 33 (1): 129-137.

    BackgroundGiven that prescribing practices have contributed to the current opioid epidemic and that primary care clinicians are the largest prescribers of opioids, family physicians must consider the twin goals of safely prescribing opioids for patients with chronic pain while effectively identifying and treating those who have developed opioid use disorder (OUD). However, family physicians may feel constrained by a culture and systems in their offices that do not support achieving these twin goals.MethodsIn a family medicine clinic within a larger academic institution that cares for an underserved, multicultural patient population in the greater Boston area, we provide a case study that illustrates the twin goals of safe opioid prescribing and treating OUD. We used 2 models of change management-Lewin's Three-Step Change Theory and the McKinsey 7S Model of Change-as a framework to describe our 5-year process of using cultural and structural elements to support these efforts.ResultsDeliberate use of change management theory to support both safe opioid prescribing and treating patients with OUD over the past 5 years resulted in changes to the practices, people, skills, and infrastructure within our clinic. These changes have demonstrated a sense of stability and sustainability and hence now represent our clinic's current culture.ConclusionThe Lewin and 7S models of change can be helpful guides to creating and maintaining a foundation of office-wide culture and structural support to meet the twin goals of safe opioid prescribing and treating patients with OUD.© Copyright 2020 by the American Board of Family Medicine.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…