WHoOpSafe

Last updated 2023-07-28T13:38:45Z

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.

Origin:

November 2016, Primary Care

Adoptions:

3 successful

Awards and Recognition:

VHA Shark Tank Winner

Partners:

Diffusion of Excellence

Overview

The 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.

The 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.

The 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 ... 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 format. To date, two cohorts of ~10 patients each, completed the 10 week virtual Whole Health SMA for ~100 encounters. Patients reported high satisfaction with the mode of care as they felt their health care needs were addressed at the virtual meetings. 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)

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

Handout for Patients with extensive information on Safely using opioids TakingOpioidsResponsibly

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 2020-07-09T12:26:23Z

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 joseph.moates@va.gov 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

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