The goal of this stepped-wedge cluster randomized trial is to evaluate whether an opioid stewardship intervention improves post-operative opioid prescribing practices. Participants will include surgeon champions and identified change team members (e.g., pharmacists, hospitalists, nurses, advanced practice providers, anesthesiologists, etc.) and patient representatives at designated hospital sites in North Carolina. The main questions it aims to answer are: I. Does the intervention reduce postoperative opioid prescribing behavior at the surgeon and hospital level? II. Is the intervention acceptable, feasible, and effective for implementation among participating hospitals? Researchers will compare opioid prescribing and implementation outcomes across sites before and after implementation using a stepped-wedge cluster randomized design, in which sites are randomly assigned to different intervention start times. Participants will attend educational sessions delivered, introduce the Standard Opioid Prescribing (SOPS) Toolkit into their clinical practice, review benchmarked, deidentified opioid prescribing performance reports that use administrative claims data (secondary data source, data not collected or shared between hospitals), and complete surveys assessing intervention acceptability, feasibility, and effectiveness. Preliminary effectiveness will be assessed through reduction of opioid prescriptions using administrative claims data.
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Acceptability of the Intervention Assessed by Semi-Structured Interviews (Change Team Members)
Timeframe: From enrollment through 6 months after completion of the 10-week intervention period
Proportion of training and learning sessions attended (Feasibility Measure 1)
Timeframe: From enrollment through 6 months after completion of the 10-week intervention period
percentage of change team member providers that completed pre- and post- assessments (Feasibility Measure 2)
Timeframe: From enrollment through 6 months after completion of the 10-week intervention period
change team's ability to start the trial as randomized (Feasibility Measure 3)
Timeframe: From enrollment through 6 months after completion of the 10-week intervention period
proportion of intervention components implemented (Feasibility Measure 4)
Timeframe: From enrollment through 6 months after completion of the 10-week intervention period
Change in Organizational Readiness to Change (ORIC) Measure (Effectiveness Measure 1- survey)
Timeframe: From enrollment through 6 months after completion of the 10-week intervention period)
Audit and feedback effectiveness as assessed by learning sessions and semi structured interviews (Effectiveness Measure 2)
Timeframe: Intervention Period
Change in Milligram equivalents (MME) of the first post-operative fill pre- and post-intervention using administrative claims data (Effectiveness Measure 3).
Timeframe: Comparing pre (6 months before enrollment) and 6 month period starting at the end of the 10-week intervention period.