St. Claire Medical Group (SCMG) Shared Vision Helps Lower Chronic Opioid Use


More than 1,000 patients at SCMG have discontinued chronic opioid use, which represents more than 30% of identified patients using ongoing prescriptions.


Located in eastern Kentucky, SCMG’s population is situated in the heart of one of the largest regions of opioid addiction and overdose – and had scarce resources available to address the issue.

Our Approach

Working with SCMG physicians and health system executives, a 3½ page Shared Vision document was developed, which defined the ideal future group (ten years in the future). While the development was more complex, the concept centered on how the group must evolve to meet the needs of the patients, the providers, and the hospital while becoming a group with which the physicians would be proud to be associated. The resulting Shared Vision consisted of ten primary elements, which became a “constitution” for the group and a roadmap for the group’s evolution.

Three of the vision elements particularly relate to this case study. First, the vision addresses the need to formally designate SCMG physician leaders, embed these leaders in a revised organizational structure, and support these leaders with a formal physician advisory council to ensure the insights of the physicians could be harnessed. Second, it pursues the adoption of clinical best practices – particularly those impacting population health – and systematically incorporating those into daily patient management activities. Third, the vision considers provider well-being, acknowledging that building a great group was not possible if the providers did not feel respected, engaged and happy with the group.

Results and Impact

To date, just over 1,000 patients have successfully discontinued their use of chronic opioids. Patient and physician acceptance of the approach and resulting outcomes has been high. They are gratified by the perceived improvement in patient care and are pleased that they and their patients are well-supported by appropriate resources to combat this significant public health issue.

The project continues to address and work with the remainder of the original 3,200 chronic opioid use patients, monitor adherence to the established prescribing guidelines, and recruit newly identified patient participants into the program. Planned next steps for their opioid stewardship program include adoption of a similar approach to address opioid use in acute pain management.

St. Claire’s CMO, Will Melahn, MD, indicates that the program could not have been conceivable, let alone achieve success, had SCMG not developed a Shared Vision for the group that catalyzed changes in physician leadership and group culture.

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Case Study – Clinical Quality Improvement.pdf
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