MNO-OB Getting Started

1. MNO-OB Team Kickoff Slide Set *New*
2. 11 Steps to Getting Started with the ILPQC Mothers and Newborns affected by Opioids (MNO) – OB Initiative

MNO-OB Data Forms and Measures

3. Mothers and Newborns affected by Opioids Aims and Measures
4. Mothers and Newborns affected by Opioids OB Data Form *UPDATED*
5. Mothers and Newborns affected by Opioids OB-Neo Combined Data Form *UPDATED*
6. Mothers and Newborns affected by Opioids Monthly Structure Measures Data Form *UPDATED*
7. MNO OB Monthly Documentation of Screening for Maternal Opioid Use Disorder *UPDATED*

MNO-OB QI Resources

8. Mothers and Newborns Affected by Opioids Initiative Slide Set adapted from ACOG District II Slide Deck and Resources*
9. MNO 6 Key Opportunities for Improvement
10. Mothers and Newborns affected by Opioids Key Drivers Diagram
11. Mothers and Newborns affected by Opioids OB Readiness Survey
12. Plan-Do-Study-Act Worksheet

Obstetric Care for Women with Opioid Use Disorder Bundle and Resource Listing, by the Alliance for Innovation on Maternal Health (AIM) and Council on Patient Safety in Women’s Healthcare*

1. 1. Bundle
   2. Resource Listing
   3. Maternal OUD Resources *New*
   4. AIM Opioid Collaborative Chart *New*
   5. AIM Opioid Implementation Guide *New*
   6. AIM Opioid Metrics (with notes & glossary) *New*

ACOG Committee Opinions*

1. ACOG Committee Opinion #711: Opioid Use and Opioid Use Disorder in Pregnancy*
2. ACOG Committee Opinion #742: Postpartum Pain Management*
3. ACOG Committee Opinion #633: Alcohol Abuse and Other Substance Use Disorders
4. ACOG Committee Opinion #473: Substance Abuse Reporting and Pregnancy – the Role of the OBGYN

1. Example screening tools (These tools screen for increased risk of substance abuse. Screen positive patients should be assessed for OUD with follow-up questions and SBIRT protocol)

1. 1. NIDA Quick Screen*
   2. 5P’s Screening Tool & Follow-up Questions*
   3. Institute for Health and Recovery Integrated Screening Tool (includes 5P’s)*
   4. Single item/question screening
   5. AIM Opioid Screening Tool Chart *New**
   6. AIM Screening Slides *New**

Additional Screening tools

1. 1. CRAFFT
   2. Substance Use Risk Profile Pregnancy Scale

Comparison and validation of screening tools for substance use in pregnancy: a cross-sectional study conducted in Maryland prenatal clinics

Key OUT/SBIRT Clinical Algorithm Resources:

1. OUD/SBIRT Clinical Algorithm
2. MNO-Neonatal Nursing Workflow
3. MNO-OB Missed Opportunities Review / Debrief Form – tool to review monthly OUD cases to provide feedback to clinical teams
4. ILPQC SBIRT Pocket Card

Additional SBIRT Resources:

1. ILPQC MNO-OB Provider / Prenatal Site Letter*
2. MA Perinatal SBIRT Pocket Card
3. Example IHR Integrated Screening & SBIRT 1-Pager
4. Helping women get Treatment: Screening and diagnosis of OUD overview*
5. Screening for Substance Use using an SBIRT Framework (step-by-step how to develop a screening protocol)*
6. Example Process Flow Map for SBIRT at Initial OB Visit*
7. Example Protocol for Women who Endorse or Screen Positive for OUD to Link to Substance Use Care Services*
8. Example Algorithm/Process Flow for Substance Use Screening in Pregnancy (Prenatal and Labor and Delivery)*

1. MNO-OB: Making Change Happen
2. MNO-OB OUD Protocol
3. MNO-OB Grand Rounds Slide Set (coming)

Mapping Local Resources for Addiction / Behavioral Health Care for pregnant /postpartum women with OUD

1. ILPQC Mapping Tool to map local resources* (Should share document with all units at your hospital that care for pregnant women and affiliated prenatal outpatient sites)
2. IDPH Opioid Use Treatment Resources for Pregnant Women with Medicaid in Illinois
3. Illinois Department of Children & Family Services (DCFS) Service Provider Identification & Exploration Resource (SPIDER)
4. AIM “Questions for States to Consider” Outpatient Engagement Strategies *New*

Buprenorphine Training for OB providers

1. SAMHSA MAT Website
2. ASAM Buprenorphine Prescribing Resources
3. ASAM Buprenorphine Billing and Coding Resources
4. ASAM Treatment of OUD Resources
5. Providers Clinical Support System (PCSS) MAT Education, Mentoring, and Resources
6. Providers Clinical Support System (PCSS) MAT Training Courses
7. Providers Clinical Support System (PCSS) MAT Clinical Mentoring
8. Providers Clinical Support System (PCSS) MAT Resources
9. Treatment Improvement Protocol: TIP 40: Clinical Guidelines for the use of Buprenorphine in the Treatment of Opioid Addiction

1. ILPQC OUD Clinical Care Checklist*
2. Example Checklist for Providers for Prenatal/Intrapartum/Postpartum Care of Pregnant Women with Substance Use Disorders*
3. Example Checklist to Optimize Prenatal Care for Women with OUD, Chart Template*
4. AIM Opioid Use Disorder Chart Checklist *New**
5. Example Best Practice Recommendations for Prenatal/Intrapartum/Postpartum Care Complicated by Substance Use Disorders*

Additional Checklist Resources to Optimize Care for Women with OUD

• Breastfeeding Guidelines for Women with a Substance Use Disorder*
• NNEPQIN – Helping Women Address Behavioral Health and Psychiatric Needs
• NNEPQIN – Strategies for Treating Concurrent Tobacco Use Disorder
• NNEPQIN – Federal Legislation Regarding Infant Plan of Safe Care
• SAMHSA – Clinical Guidance for Treating Pregnant Women and Parenting Women with Opioid Use Disorder and their Infants – Section III: Maternal Postnatal Care (Section III: Maternal Postnatal Care, Factsheets 14-16)
• Prescribing Guidelines from Pennsylvania: Use of Addiction Treatment Medications (MAT) in the Treatment of Pregnant Patients with Opioid Use Disorder
• SAMHSA Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and their Infants: Planning Prior to L&D, Peripartum Pain Relief: SAMHSA – Clinical Guidance for Treating Pregnant Women and Parenting Women with Opioid Use Disorder and their Infants – Section I: Pernatal Care (Section I: Prenatal Care, Factsheets 7 & 8)
• Ohio MOMS Maternal Opiate Medical Support Care Coordination Model

1. Narcan- Save a Life Poster
2. AMA: Help save lives: co-prescribe naloxone to patients at risk of overdose*
3. Naloxone Rescue Kit Consultation Checklist*
4. Narcan Nasal Spray – Quick Start Guide*
5. Narcan Prescription Aid– Bring to Pharmacy to Purchase Narcan Nasal Spray

All MNO-OB Folder Materials (Download all here)

Patient Education Materials (Give to and review with moms)

• Prescription Pain Medicines and Pregnant Women
• NAS- You are the Treatment
• NAS: What you Need to Know
• Contraception Counseling for Women with OUD

Clinical Team Resources (Give to OB & Nurse to complete)

• OUD/SBIRT Clinical Algorithm
• OUD Clinical Care Checklist
• Narcan- Quick start guide & Save a Life Flyer for OB to review and prescribe to patient
• OUD Protocol
• Nurse Workflow

General Information for Women with OUD

1. General patient education: Pain medications, opioids and pregnancy
2. Pregnancy and MAT one-pager
3. Are you in Treatment or Recovery? Contraception Counseling for Women with OUD,  from OPQC

Increase maternal participation in the care of opioid exposed newborns

1. NAS booklet  (you are the treatment for your baby)
2. NAS what you need to know one-pager

MNO-OB Provider Education Campaign *NEW*

1. Set up an MNO-OB Grand Rounds / OB Provider Meeting by contacting us at info@ilpqc.org 
2. SBIRT Simulation Guide– includes 4 case studies with sample screening tools and participant assessments.
3. Provider Poster (Mom & Baby)
4. Provider Poster (Provider & Woman)
5. Narcan- Save a Life Poster
6. MNO OB Office Flyers
7. SBIRT eModules
   1. IRETA eModule
   2. ACOG District II SBIRT Training
8. Reducing Stigma & Bias Resources
   1. Words Matter (filmed at ILPQC 5th Annual Conference- 2018) – eModule for Providers, Nurses, and Staff about OUD as a chronic illness, stigma and bias*
   2. Beyond Labels: Do Your Part to Reduce Stigma (March of Dimes)

Provider/Nursing/Staff Education on OUD

1. Free Online CME Courses from UIC College of Medicine (For MD, NP, PAs) including MAT Induction and Follow-up; Trauma Informed Care, NAS and More!
2. SBIRT Implementation eModule (90 min)
3. Pause Before You Prescribe – ILPQC hand out for all providers / nurses focused on safe prescribing for pregnant women*
4. Words Matter: How Language Choice Can Reduce Stigma – Provider / Nurse education
5. CDC  Guideline for Prescribing Opioids for Chronic Pain – hand out for providers/nurses
6. Provider Training with CDC e-modules: Applying CDC Guidelines for Prescribing Opioids

1. Avoid overprescribing at delivery graphic
2. A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery – article and powerpoint tool*
   1. Article
   2. Powerpoint
3. Example Enhanced Recovery After Surgery (ERAS) Pathway for Cesarean Section*
4. Example SBAR: removing opioids from order sets to reduce opioid over prescribing at delivery
5. Overview of State Law for ILPMP Lookup and Documentation*
6. ILPMP Registration webpage
7. ILPMP example script for documentation