Evaluation - Six Building Blocks: Team Based Opioid Management in Primary Care

Learning Objectives

At the end of this webinar participants will be able to... 1. Describe current challenges to managing opioid medications for individuals with chronic pain in a primary care setting. 2. Examine the six building blocks needed to build a quality improvement road-maps to help primary care teams become effective. 3. Identify at least 2 tools or strategies that can be applied in a primary care setting to address opioid use for long-term pain management.

1. Did the training meet all of the stated learning objectives?

1 - The learning objectives were not met 2 - The learning objectives were somewhat met 3 - The learning objectives were mostly met 4 - The learning objectives were completely met.

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2. The scholarship and expertise of Michael Parchman, MD, MPH?*

1 - Poor 2 - Slight 3 - Moderate 4 - Excellent

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3. Your overall satisfaction with this webinar training?*

1 - Dissatisfied 2 - Somewhat satisfied 3 - Mostly satisfied 4 - Completely satisfied

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4. The webinar presented new areas of knowledge, and/or new ideas/methods to implement.*

1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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5. The webinar contained information at a level commensurate with my training and experience.*

1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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6. How helpful was the information you learned today in enhancing the performance and operations of your health center?*

N/A - Not applicable 1 - Not helpful 2 - Somewhat helpful 3 - Mostly helpful 4 - Completely helpful

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7. If applicable, how do you plan to use the information you learned in your daily work?*

Please do not leave blank. Answer "N/A" if you have nothing to enter for this question.

8. Was the content balanced and free of commercial bias?*

1 - Yes 2 - No

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9. Did the speaker(s) fully disclose any conflict of interest and discussion of off-label usage of medications and/or medial devices?*

1 - Yes 2 - No

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10. Do you have any training, technical assistance, or resource needs? If so, please specify below.*

If you do not have any training or technical assistance needs please reply "None"

11. What is the biggest challenge for your clinic in providing quality care to patients?*

If your clinic does not have any challenges, please reply "None"

12. Additional Comments?*

If you do not have any additional comments, please reply "None"

CERTIFICATES FOR THIS TRAINING WILL BE SENT ELECTRONICALLY. IF YOU WISH TO RECEIVE A HARD-COPY OF YOUR CERTIFICATE, PLEASE MAKE SURE TO FILL IN ALL APPROPRIATE FIELDS BELOW.

13. Name (as it should apprear on your certificate)*

14. Please identify the type of organization you represent.*

1 - PCA (Primary Care Association) 2 - Health Center 3 - HCCN (Health Center Controlled Network) 4 - State/Federal Government Agency 5 - Other / Not included in this list 6 - I'm not sure / Don't know

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15. Please identify the type of certificate you would like to receive.*

NOTE: TEXAS CHW CERTIFICATES ARE NOT AVAILABLE FOR THIS ACTIVITY 1 - Continuing Medical Education (CME) 2 - Continuing Nursing Education (CNE) 3 - Texas CHW Certificate 4 - Certificate of Attendance

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16. Address (Street Address or P.O. Box)*

17. City*

18. State*

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19. Zip Code*

20. E-mail Address*

21. Phone Number*

Please enter your phone number in one of the following formats: xxx - xxx - xxxx OR (xxx) xxx - xxxx

22. Please indicate the type of phone number you provided.*

1 - Cell/ Mobile 2 - Home 3 - Work/Office

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