Physician Coaching to Reduce Opioid-related Harms

This project addresses the urgent need to promote the adoption of evidence-based practices in
healthcare by pilot-testing an innovative implementation strategy. The implementation
strategy aims primarily to reduce variation in opioid prescribing practices for chronic pain
in primary care settings.

The standard approach to improving medical practice involves groups of clinical experts
reviewing the literature to produce clinical guidelines based on scientific evidence, and
disseminating those guidelines by publishing them in medical journals. A clinical guideline
has been developed for opioid prescribing for chronic non-cancer pain using this type of
approach. The implementation strategy for promoting uptake of the guideline in primary care
settings tested in this study consists of three innovations: (1) a process for translating
clinical guidelines into a checklist-based implementation guide for clinicians, (2) a
physician peer coaching model, and (3) implementation support using tools from systems
engineering. This project teams the experts who developed the guideline for opioid
prescribing with experts in implementation science and primary care to translate the
guideline into an actionable, checklist-based implementation guide. If the implementation
strategy is effective in this pilot test, it will be used in a larger cluster-randomized
trial to test it against other approaches to evidence-based practice adoption.The long-term
goal of this research is to improve the adoption of evidence-based practices in primary care
by producing a generalizable model of change.

Inclusion Criteria:

At each of the 4 coaching intervention sites, we aim to recruit between 3-7 clinical care
providers with prescribing authority (e.g., primary care physicians, mid-level
practitioners, etc.) to participate in interviews and focus groups. All clinic staff (e.g.,
medical assistants, office staff) are welcome to participate in coaching site visits and
follow up correspondence, but only staff with prescribing authority will be considered
research participants.

Exclusion Criteria:

- Residents will be excluded.