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WHoOpSafe

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Opioid reliance in chronic conditions can be mediated through Whole Health (WH) approaches and interventions within a Shared Medical Appointment (SMA). Veterans on chronic opioids for treatment of pain attend a series of SMAs to learn about a Whole Health approach for managing pain. Veterans partner with the care team to develop shared goals that promote wellness and well-being.

This innovation is replicating across multiple facilities as its impact continues to be validated. See more replicating innovations.

Origin:

November 2016, Primary Care

Adoptions:

3 successful

Awards and Recognition:

VHA Shark Tank Winner

Partners:

Diffusion of Excellence

Tags:

COVID-19 Outpatient Care Primary Care Telehealth Whole Health
Contact Team

Overview

Problem

Our Patient Aligned Care Team set out to develop a program that would help patients working alongside their Primary Care Team, and reduce their reliance on opioids for treatment of chronic pain.

Solution

Develop a Shared Medical Appointment (SMA) clinical pathway using the Whole Health conceptual framework curriculum to equip clients to make meaningful changes in their lives, improve self-care modalities for better pain management, and reduce opioid reliance.

Results

Patients participating in this program have made substantive reductions in their use of opioids for treatment of chronic pain, have increased their learning of opioid safety, and incorporated complementary and integrative modalities for managing pain into their lifestyles. In 2020 in response to the Covid-19 Pandemic, in-person SMAs were converted to VVC for ... See more

Metrics

  • 20% of patients have been tapered off opioids while 34% have reduced opioid dose by 25 to 99%.
  • Morphine Equivalent Daily Dose for all patients combined has decreased by >50% over 4 years.
  • Many patients incorporated a complimentary/integrative modality into their pain management.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AL: Birmingham VA Medical Center (Birmingham, Alabama) AL: Huntsville VA Clinic (Huntsville) MA: West Roxbury VA Medical Center (West Roxbury)
  • Started adoption on 08/2020.

There are no in-progress adoptions for this innovation.

There are no unsuccessful adoptions for this innovation.

Implementation

Timeline

  • 4-8 hours
    Identification of adopting team members
  • 14 hours
    Training in how to have a Whole Health Shared Medical Appointment (SMA)
  • 8 hours
    Determining start date, who to invite, setting up a clinic grid
  • 4 hours
    Scheduling patients for the SMA
  • 4 hours
    Sending letters to patients for the SMA
  • 4 hours for SMA
    First SMA ~45 days after initial contact

Departments

  • Mental health care
  • Social work
  • Pharmacy
  • MOVE! weight management
  • Physical medicine and rehabilitation
  • Physical therapy, occupational therapy and kinesiothology
  • Primary care
  • Whole health

Core Resources

Resource type Resource description
PEOPLE
  • Clinical Application Coordinator 2-4 hours/week

Files

Risks and mitigations

Risk Mitigation
Team does not adopt and work together, lack of patient engagement Whole Health implementation specialist partners
Patients do not continue to attend SWOT analysis to identify barriers to participation
Adopting team lethargy due to too eager to see results Partner with successful teams to regain vision

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (Medical Support Assistant) Innovation adopter posted

As a team member I strongly feel that teamwork makes the dream work always remember sharing is caring and as each member effectively commit to their role, miracles will be manifested.

Email

Email with questions about this innovation.

About

Origin story

At the Birmingham VA medical center, we developed a Whole Health patient-centered Shared Medical Appointment (SMA) to serve the needs of Veterans who take chronic opioid medicine for pain. The program allows the client to pick a program of healing of their choice and partner with their health care team to achieve shared goals.

Original team

joseph.moates@va.gov

Primary Care Provider

Search tags

COVID-19 Outpatient Care Primary Care Telehealth Whole Health