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Bringing Our Patients COMFORT

Mother and newborn baby

Background

OBI is working with 70+ hospital teams in Michigan to help maternity clinicians adopt new national guidelines to promote excellent postpartum pain control, reduce harmful opioid prescribing, and promote more equitable, respectful care.

The Problem

Postpartum individuals are a critical but neglected population for opioid stewardship. Opioid prescribing after childbirth is excessive, risky, and variable. 

20%

Proportion of prescribed opioids actually consumed after cesarean

1 in 75

Number of people with new persistent opioid use after initiating an opioid postpartum

32.9-100%

Variation in opioid prescribing after cesarean birth in Michigan hospitals (2023)

Aim

The Creating Optimal pain Management FOR Tailoring interventions after childbirth (COMFORT) Clinical Practice Guideline (CPG) was developed to optimize postpartum pain management.

By December 2025, more than 70% of participating hospitals will offer COMFORT CPG-concordant care.

Goals

  • ≥ 70% of clinicians trained on COMFORT guideline
  • ≥ 90% of eligible births receive opioid-sparing postpartum pain management

Implementation Resources

Initiative Background

COMFORT Panel Recommendations. for Opioid-Sparing Pain Management After Childbirth

A high-level overview of the new national COMFORT Clinical Practice Guideline (CPG) to improve leadership awareness & buy-in, and to inform decision-making, resource allocation, and quality improvement strategies.

QI Planning & Implementation Tools

A practical guide for clinicians implementing the COMFORT (Creating Optimal pain Management FOR Tailoring interventions after childbirth) Clinical Practice Guidelines.

A collection of resource examples that may be modified to aid in site-specific workflows.

Presented by Kimberly Brown, MPH, & Alex Peahl, MD, MSc. OBI Fall 2023 Semiannual Meeting Breakout Session. View the slides.

A checklist is designed to help quality improvement (QI) champions link barriers/facilitators to QI strategies that will promote successful clinical practice change efforts and adoption of the COMFORT Clinical Practice Guideline (CPG).

Presented by Alex Peahl, MD, MSc, and Michelle Moniz, MD, MSc. OBI Webinar Series, February 2024.

(OBI Members Only). View the Recording & Slides.

Clinician Engagement

Presented by Alex Peahl, MD, MSc. OBI Webinar Series, October 2023.

(OBI Members Only). View The Recording & Slides.

Optimizing Maternal and Neonatal Health: Strategies for Screening, Diagnosing, and Treating Substance Use Disorders in Pregnancy

This 1-hour OPEN training featuring Dr. Alex Peahl focuses on actionable strategies for screening, diagnosing, and treating substance use disorder in pregnancy.

Patient Engagement

An Opioid Prescribing Engagement Network (OPEN) Patient Brochure: Learn about naloxone and how to safely administer it.

An Opioid Prescribing Engagement Network (OPEN) Patient Brochure: Learn how to safely store and dispose of opioids.

An OBI & Opioid Prescribing Engagement Network (OPEN) Patient Brochure: Learn ways to manage pain after childbirth such as over-the-counter medications, non-medication strategies, and opioids, if prescribed.

An Opioid Prescribing Engagement Network (OPEN) Patient Brochure: Learn how to help manage or reduce your pain and anxiety through various techniques.

MDHHS Opioid Start Talking form to be completed and saved to the patient’s medical record when prescribing an Opioid drug.