Broad engagement across the health plan is essential to the success of your opioid safety initiative. We recommend building a coalition of key stakeholders, including board members, executive leadership, and departmental leadership. In this section we provide a motivational interviewing guide that can help you assess their readiness to lead a change effort.
How to Do It
- Enlist board members around issues of member safety and the need to manage reputational and other risks associated with the epidemic.
- Enlist executive leadership around the business case for action.
- Bring together departmental leaders around the need for workable policies that minimize unintended consequences.
- Begin with a “coalition of the willing” and expand over time.
Health Plan Stories
Blue Shield of California
Blue Shield of California recognized that addressing the opioid crisis would not be just a pharmacy initiative.
The team developed pharmacomedical analytics with a data-driven dashboard to look at the key medical and pharmacy metrics, assess the impact of interventions, and evaluate progress over time. Analytic support and expertise were key elements of the initiative; data-driven insights helped guide and inform the leadership team. For example, the analytic model to identify and exclude members from interventions and reporting (e.g., those with cancer, in hospice or palliative care, etc.) based on information available to the health plan required refinement over time because it was not as straightforward as originally thought.
An internal governance structure provides accountability for the initiative. A steering committee and workgroups meet routinely to develop and monitor activities, and results of the initiative are reported through Blue Shield of California’s quality committee structure. An unplanned result of this enterprise approach is the ability for the plan to address new national quality measures on opioid use (see more at www.ncqa.org).
Inland Empire Health Plan and the Inland Empire Opioid Crisis Coalition
Inland Empire Health Plan (IEHP) assumed organizational and administrative responsibility for the coalition in mid-2017.
Kaiser Permanente of Southern California
Recognizing that the opioid crisis touched the entire organization, Kaiser Permanente Souther Calfornia (KPSC) formed a multidisciplinary steering committee. It had representation from all major departments, including pharmacy, pain management, adult primary care, surgery, emergency room / urgent care, addiction treatment, and hospitalists, among others.
Partnership HealthPlan of California
Using a quality-improvement methodology, Partnership HealthPlan of California (PHC) developed a driver diagram, identifying the levers it could use to drive change internally.
Motivational interviewing is a tool to assess and promote organizational alignment. Through interviews or surveys, you can gather information about stakeholders’ views on the opioid crisis, the role of your organization, potential benefits of an initiative, as well as potential objections or challenges.
The guide below outlines an approach to conversations with stakeholders, such as your department leaders (e.g., pharmacy director, member services director) and board members, that is grounded in listening and collaborative planning to achieve mutually beneficial goals. You can document your assessment of each stakeholder in the Stakeholder Readiness Assessment Tool (ZIP) to produce a heat map of the organization to show where you have pockets of support or resistance.
Download this tool: Motivational Interviewing Guide (PDF)