A cornerstone of quality is that the care that patients
receive should be safe and effective. Avoiding new starts of opioids when other
treatment options may be more appropriate can help to prevent long-term use,
which can lead to significant harm.
The priorities for the 2019/20 QIPs include a new indicator for the primary care sector
that measures the
non-palliative care patients newly dispensed an opioid.
The opioid may be
dispensed by any provider in the health care system (e.g., family physicians,
nurse practitioners, dentists, or surgeons) within a six-month reporting
Review the Indicator Technical Specifications for the 2019/20 QIPs to learn about how to measure
How this indicator is
This indicator is one of several opioid-related indicators
shared with family physicians in
MyPractice Reports enable family physicians to confidentially see their
individual opioid prescribing patterns in relation to peers across the
The data presented in MyPractice Reports are obtained from
administrative data sets that include data on patients rostered to physicians.
Because of how this data is collected, these reports are not available for
nurse practitioners at this time. Health Quality Ontario is working to develop a custom indicator
that can be used by organizations that cannot receive MyPractice Reports (for
example, nurse practitioner-led clinics and Aboriginal health access centres).
on this indicator
Check out the following key resources to support appropriate
prescribing of opioids:
Given that the indicator measures opioids dispensed by any
provider in the health care system, it will be important for primary care
organizations to collaborate with other organizations in their community to
achieve improvement on this indicator.
To reduce the percentage of non-palliative care patients
newly dispensed an opioid, primary care organizations could consider the
- Providing comprehensive assessments for patients with pain
- Ensuring health care providers receive appropriate education
on pain management
- Ensuring patients receive information on the benefits and
harms associated with opioid use
1. Provide comprehensive
assessments for patients with pain
Patients with pain should receive a comprehensive,
standardized assessment to guide pain management. To support this, primary care
organizations could work to ensure that the right systems, processes, and
resources are in place to support clinicians in performing these assessments.
Health Quality Ontario’s quality standards for opioid
chronic pain and acute pain include information about delivering comprehensive assessments,
including related process measures to capture the changes your quality improvement
efforts are making.
Also review the Management of Chronic Non-Cancer Pain Tool, which is designed to assist primary care
providers in developing and implementing a plan for adult patients living with
chronic pain and applies to chronic non-cancer pain. Specifically, Section 1:
Baseline and ongoing assessment will be helpful to conduct assessments.
2. Ensure health care
providers receive appropriate education on pain management
Ensuring that health care providers have access to
evidence-based, unbiased interprofessional educational opportunities can help
improve their ability to provide multimodal treatment for chronic and acute
Review the educational resources and supports for health
care providers among Ontario's
Ontario Pain Management Resources.
3. Provide patients with
information on the benefits and harms associated with opioid use
Patients should be well supported with information about
pain management, including the potential benefits and harms of opioid therapy
at the time of both prescribing and dispensing. This information could be
provided both verbally and via printed or multimedia formats.
Health Quality Ontario offers patient reference guides for
opioid prescribing for
chronic pain and acute pain to help patients know what to ask when receiving treatment. Choosing
Wisely Canada also offers
opioid information for patients, including a list opioid-related side effects and
alternative pain treatments.
Visit Quorum’s Indicators & Change Ideas page for more information on this indicator.
Are you interested in
learning more about how health care providers are addressing this issue in
Ontario? Search for the
on Quorum to read the most up-to-date posts related to this topic.
This year’s Quality
Improvement Plan (QIP) program focuses on a smaller number of priorities with
an emphasis on critical issues that require a cross-sector focus. The
priorities focus on three core themes: timely and efficient transitions,
service excellence, and safe and effective care. Each theme includes a list of
indicators that organizations are strongly encouraged to work on throughout the
This post is part of a
series highlighting the new themes and 2019/20 QIP indicators. Visit the
tag to see the latest.