Improving Clinical Practice with Patients who have Opioid Use Disorder (OUD)

The American Academy of Addiction Psychiatry and the PCSS team have created a Performance-in-Practice (PIP) activity to help you and your practice treat opioid use disorder.

A PIP activity is a Performance Improvement CME (PI CME) activity designed to assist physicians, PAs, nurses, and nurse practitioners in determining individual practice gaps and addressing them through a performance improvement plan designed to increase competence, performance, and patient outcomes. The PIP will walk you through Three Stages (A, B, and C) in a process to enhance practice of the treatment of patients with opioid use disorder. It is recommended that the PIP take 3 months or more to complete, though it may take significantly longer (as long as deemed necessary to plan, implement, and evaluate your educational plan). This PIP follows the AMA-standardized three-stage process of a PI CME. It includes the following stages:

  • Stage A: Assess: Assess your current practice against current evidence and expert consensus.
  • Stage B: Apply: Develop and follow your own improvement plan.
  • Stage C: Evaluate: Reassess your practice to measure the effects of your improvement plan.

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Frequently Asked Questions

What is a Performance-in-Practice (PIP) activity?

A Performance-in-Practice (PIP) activity is a Performance Improvement CME (PI CME) activity designed to meet the Maintenance of Certification (MOC) requirements of select ABMS organizations. However, this PIP activity will fulfill the American Board of Psychiatry and Neurology (ABPN) Part 4 PIP requirement for MOC. It mandates that diplomates complete quality improvement programs designed to improve practice over the MOC cycle.

This PIP activity will assist physicians, PAs, nurses and nurse practitioners to determine individual practice gaps and address them through a performance improvement plan designed to improve competence, performance, and patient outcomes.

Why and how often do I need to complete a PIP activity?

MOC cycles vary according to American Board of Medical Specialties (ABMS) organizations. We advise that you check with the certifying board that is relevant to you to learn your MOC fulfillment criteria and select a PIP that is relevant to your MOC requirements.

What are the different stages of a PIP activity and how long do they take to complete?

This PIP activity has three distinct stages:

  • Stage A may take up to 1-2 weeks to complete. You will begin this activity by completing a five patient chart audit to assess your clinical performance using Clinical Quality Performance Measures. The goal of this stage is to identify one clinical measure you wish to improve upon which will determine your personalized practice improvement goal.
  • Stage B may take 2-3 months* to complete. In Stage B, you will construct an effective performance improvement plan utilizing PIP tools in order to implement change on the measure you identified in Stage A. It should take at a minimum 1-2 months to integrate your improvement plan into your practice based on your selected clinical quality measure.
  • Stage C may take up to 1-2 weeks to complete. In Stage C, you will review and evaluate the effectiveness of integrating your improvement plan into your practice by reassessing your performance via chart audit.
Is there any way to complete a PIP activity more quickly?

This PIP activity is designed to take 3 months or more to complete. To maximize the utility of this PIP, we recommend you take advantage of the activity and the resources within it so you can implement lasting change in your practice. This may mean that you complete each stage in less - or in more - time than is estimated.

How many credits will I get for completing the PIP activity?

Accreditation and Certification of this activity:

Jointly Accredited ProviderJoint Accreditation Statement

In support of improving patient care, American Academy of Addiction Psychiatry is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

In 2019, AAAP also added accreditation from the American Academy of PAs (AAPA), American Psychological Association (APA) and Association for Social Work Boards (ASWB).

Release Date: September 5, 2019 Date of Expiration: September 5, 2022

IPCE CreditInterprofessional Continuing Education (IPCE) Designation Statement

This activity was planned by and for the healthcare team, and learners will receive 20 Interprofessional Continuing Education credits for learning and change.

Physician Designation Statement

American Academy of Addiction Psychiatry designates this performance improvement activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Designation Statement

American Academy of Addiction Psychiatry is an approved provider of nursing continuing education through AAAP's Joint Accreditation provider #4008192. This program is approved for up to 20 Nursing Contact Hours.

PA Accreditation

PAs may claim a maximum of 20 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credits™ from organizations accredited by ACCME or a recognized state medical society.

How is the PIP activity documented? Will I be evaluated upon completion?

Upon your completion of this PIP activity, you will receive an email supplying you with a certificate to personally document your credits. AAAP will retain the learner completion documentation for 6 years. For ABPN diplomates, AAAP will provide ABPN with a completion report.

I am ABPN board-certified. How will my board be informed?

AAAP will submit your completion information to ABPN by a reporting system provided once a month.

Once I have received my certificate, what do I do with it?

Keep your certificate for your records. You may need this as documentation at the end of your MOC-cycle.

Can I leave the activity and return to it at a later time?

Yes. Within each stage there are various chapters; you may leave a stage at any time, and when you return you will be directed to the beginning of the last chapter you visited. To avoid repeating questions, make sure you have completed all the questions in each stage, and only exit once you have reached a new stage.

How do I choose the patient charts for the chart audit?

You will pull the charts of 5 patients who have been diagnosed with Opioid Use Disorder (OUD).

Can I use the same patient charts in both Stages A and C?

If you have seen patients multiple times between Stages A and C then you may use charts from the same patients. However, Stage C is a re-evaluation of your practice, and it is essential that you use patient charts from recently seen patients at each chart review to get the most accurate examples of your patient interactions and protocols.

Can I use the same patient charts that I used in another PIP activity?

Provided that you are currently seeing the same patients and that you are also treating the patients for OUD – yes, you may use charts from the same patients.

Do I need to be a physician to participate in this PIP activity?

No. This PIP activity was developed for clinically active physicians, PAs, NPs and RNs.

How much does it cost to participate in this PIP activity?

There is no cost to participate in this PIP activity.