TY - JOUR AU - Chinman, Matthew AU - Gellad, Walid F. AU - McCarthy, Sharon AU - Gordon, Adam J. AU - Rogal, Shari AU - Mor, Maria K. AU - Hausmann, Leslie R. M. PY - 2019 DA - 2019/01/18 TI - Protocol for evaluating the nationwide implementation of the VA Stratification Tool for Opioid Risk Management (STORM) JO - Implementation Science SP - 5 VL - 14 IS - 1 AB - Mitigating the risks of adverse outcomes from opioids is critical. Thus, the Veterans Affairs (VA) Healthcare System developed the Stratification Tool for Opioid Risk Management (STORM), a dashboard to assist clinicians with opioid risk evaluation and mitigation. Updated daily, STORM calculates a “risk score” of adverse outcomes (e.g., suicide-related events, overdoses, overdose death) from variables in the VA medical record for all patients with an opioid prescription and displays this information along with documentation of recommended risk mitigation strategies and non-opioid pain treatments. In March 2018, the VA issued a policy notice requiring VA Medical Centers (VAMCs) to complete case reviews for patients whom STORM identifies as very high-risk (i.e., top 1% of STORM risk scores). Half of VAMCs were randomly assigned notices that also stated that additional support and oversight would be required for VAMCs that failed to meet an established percentage of case reviews. Using a stepped-wedge cluster randomized design, VAMCs will be further randomized to conduct case reviews for an expanded pool of patients (top 5% of STORM risk scores vs. 1%) starting either 9 or 15 months after the notice was released, creating four natural arms. VA commissioned an evaluation to understand the implementation strategies and factors associated with case review completion rates, whose protocol is described in this report. SN - 1748-5908 UR - https://doi.org/10.1186/s13012-019-0852-z DO - 10.1186/s13012-019-0852-z ID - Chinman2019 ER -