Name of Organization (s)
Delta Dental/Arcora/Healthentic
Applicable Bree Guidelines
Dental guidelines on prescribing opioids for acute pain management
Summary
Delta Dental used the Bree Collaborative guidelines for Opioid Prescribing for Dental to develop provider training and a prescribing monitoring plan. The aim of this project was to reduce opioid prescription doses and incidents for patients under age 24.
Delta Dental created provider trainings, materials, and support to educate both providers and patients. With their partner Healthentic, they monitored a subset of dentists prescribing for patients of self-insured plans and tracked their prescriptions over time.
Organization Name (s)
The Everett Clinic and the PolyClinic, part of Optum Health
Applicable Bree Guidelines
Collaborative Care for Chronic Pain
Long-term opioid therapy
Opioid Prescribing Metrics
Prescribing opioids for postoperative pain
Opioid Prescribing in older adults
Summary
The Everett Clinic used Bree Collaborative Guidelines to improve their Chronic Opioid Therapy Program. Using Bree metrics, they implemented a provider facing dashboard and provided training. The aim of this project was to identify high-risk patients and monitor their opioid prescriptions.
Organization Name (s)
Educational Service District 105
Applicable Guideines
Pediatric Asthma
Summary
Educational Service District 105 previously used Bree guidelines to provide limited training to staff. They will be implementing a program to help all staff and nurses increase fidelity with Bree guidelines. The aim of the project is to identify students missing school due to Asthma and improve their attendance, and to better identify, document, and manage students with an Asthma diagnosis.
More coming in Spring of 2025
Organization Name (s)
UnitedHealthCare
Applicable Guidelines
Behavioral Health Integration
Summary
UnitedHealthCare used the Bree guidelines and other resources to develop a Behavioral Health Integration Survey to measure the level of integration across their 60 Medicaid provider organizations. The results of the survey were used to provide integration support. They will be updating and revising this survey using Bree Collaborative guidelines and implementation resources. The aim of this project is to improve the sensitivity of the integration survey, to pilot it with two organizations that are still struggling with integration, and to spread the methods to other states in the region.
More Coming in Spring of 2025
Organization Name (s)
Washington State Department of Health, Outpatient Infection Control Network Participants (TBD)
Applicable Guidelines
Outpatient Infection Control
Summary
The Washington State Department of Health used the Bree guidelines, along with other resources, to inform the development of an Outpatient Infection Prevention Playbook for new Infection Preservationists (IPs) in outpatient settings. Their outpatient infection prevention network members contributed to the development of the playbook.
This case study will explore 1) what the Bree guidelines contributed to the playbook and 2) how organizations used the playbook in their settings.
More coming in Spring 2025
Organization Name (s)
Thurston County Department of Health
Applicable Guidelines
Heat Related Illness and Wildfire Smoke
Summary
This case study is still being defined. Thurston County and Thurston County Medical Reserve Corps members are involved in the development of their guidelines and plan to use them to inform their preparedness plans
More coming in Fall of 2025
The Bree Collaborative is actively soliciting case studies to elucidate real-world examples of implementations efforts for the guidelines we have developed.
Benefits for the partner include:
We are particularly interested in case studies which illustrate how the four pillars of out systems transformation model – Equity, Holistic, Person-Centered Care, Data Usability and Exchange, Financing models – were embedded into an implementation project.
Case study implementation projects should be able to be supported with data and, where possible, evaluation outcomes.
When feasible, the ‘voices’ of Tribal Nations, undeserved groups, rural areas, and diverse communities that were consulted during the implementation of the guideline should be heard. This can be through inclusion of quotes, interviews, or formal recognition of those who assisted, were consulted, or were served.
The Bree Collaborative has created a standard process for case study development. Any organization wishing to develop a case study, in collaboration with the Bree, can contact us or submit basic information in the form on the “Contact Us” tab. Before submission, please read through our case study guidelines to better understand the commitment involved and the steps in the process.
We will review all submissions and contact organizations either for further development or with recommendations for other information needed before development of a case study can proceed.
Bree Case Study Guidelines PDF Link
Introduction
These case study guidelines are modeled on the National Health and Medical Research Council of Australia’s guidelines for case studies.[1]
The Bree Collaborative developed a reporting system to determine the usage of Bree guidelines and the resulting impact on population health. The Bree seeks stakeholders to report on the utilization of the Bree guidelines and to develop case studies in partnership that review the implementation and communicate findings within Washington State.
Partnering with the Bree Collaborative to develop a case study provides benefits for both the Collaborative and the partner.
By working with partners, the Bree Collaborative gains access to:
Benefits for the partner include:
Development principles
In developing the case studies, the Bree Collaborative is guided by a number of principles, as set out below.
Principle 1: All Bree Collaborative Case Studies must be approved by the Foundation for Health Care Quality
Only those case studies that have been formally approved by FHCQ may be published using FHCQ/Bree template and logo. While Bree Collaborative case studies are developed collaboratively, FHCQ retains final authority over whether or not, and in what form, they are published.
Principle 2: Each case study must utilize the Bree Collaborative guidelines as all or part of an initiative
The Bree Collaborative recognizes that few, if any, impacts arising from health and medical guidelines implementation will be the result of the result of a single guideline, initiative or other activities. The Bree will only publish case studies on impacts whose underpinning is based on the implementation of our published guidelines or participation in our guideline’s development workgroups.
Principle 3: The Bree Collaborative will work closely with case study partners
The Bree’s ability to work closely with case study partners is vital to the successful and timely completion of the case studies themselves. In order to ensure the maintenance of close working relationships with partners, FHCQ/Bree:
Principle 4: All factual statements must be checked for accuracy
The Bree Collaborative actively confirms the accuracy of all factual statements contained within each case study.
Using its own internal data and information sources, the Bree verifies factual details about those measures or activities that are featured in a case study.
For content contributed by or about partners, the Bree asks the partner institution to confirm that this content is accurate, and to work with its own staff/researchers to ensure that any statements made about them are accurate.
The Bree regards partners as expert sources with respect to the claims that they make within their domains of expertise. That said, the Bree may query claims made by partners and require evidence to support these claims. The decision to publish a claim will ultimately be made by the Bree Collaborative and FHCQ.
Principle 5: Case study topics are carefully selected
The Bree Collaborative takes the following considerations into account when selecting topics for case studies:
In addition to the above, the Bree is particularly interested in developing case studies that:
Topics will be selected to ensure that, collectively and over time, the case studies reflect the diversity of the Bree Collaborative Guidelines.
Note on attribution
One of the most challenging aspects of case study development is the correct attribution of impacts1. Each case study must include reference to those individuals and organizations that made the most significant contributions to generating the impact being described.
As any given impact will usually have resulted from the work of a range of individuals and organizations, and because of the limited space available within the Bree Collaborative case study template, it may not be possible for a case study to refer to everyone who made a contribution to the impact. Those included will be selected on a number of criteria, including the degree and type of support that they provided.
While the Bree is not able to include every involved individual and organization within any given case study, it can develop additional case studies within the same guideline topic or impact area. Please contact the case study development team if you are interested to pursue this option.
Principle 6: Case studies are drafted in plain English
The Bree Collaborative case studies strive to translate technical research and commercial language into plain English that can be easily understood by a non-academic audience. Consequently, some technical information and content provided by partners may be edited to simplify it and to align it with the Bree’s style guide. The Bree Collaborative retains final editorship of all case studies to ensure a consistent tone and style.
Principle 7: Case studies are intended to be used
The Bree Collaborative produces case studies to increase public awareness of the role that health and medical research has played, and continues to play, in building a healthier Washington State. Because promotion is essential to ensuring that case studies reach their intended audiences, The Bree Collaborative actively seeks opportunities to cross-promote each case study with its partner organization(s).
Development stages
The process to develop a case study follows the stages set out below.
Stage 1: Planning the case study
A small team within the Bree Collaborative is responsible for leading the development of case studies. When a submission for a new case study has been submitted to the Bree or a project has been identified, the team undertakes background research to determine how well the case study aligns with the current work when considering further development.
Stage 2: Developing drafts
The Bree staff work closely with the submitting partner(s) to develop draft text for the case study that can be placed into the case study template, then prepared for approval by the partner and ultimately by FHCQ/Bree.
Partners have ongoing opportunities to review drafts and provide comments during this process.
The working relationship with partners is informed by Principle 3 and Principle 4.
Stage 3: Fact and integrity checking
Prior to being published, each case study must receive clearance both from the partner and from FHCQ/Bree.
Partners are asked to verify details mentioned in the case study, including such things as publications, patents, curriculum vitae details, timeline dates, conflict of interests and a range of other issues. Fact checking is undertaken consistent with Principle 4.
Clearance within FHCQ/Bree includes ensuring that the case study:
Final approval to publish must be granted by FHCQ Chief Executive Officer (CEO).
Stage 4: Publishing
Subject to approval to publish by the CEO, the Bree prepares the case study for uploading onto its website and develops any other supporting material. This process may include the development of a cross-promotion strategy with the partner. Partners are kept informed of the likely timing of publication.
Questions
Any questions about the content and/or application of these Guidelines should be addressed to bree@qualityhealth.org
FOOTNOTES:
1A detailed discussion of attribution may be found within CSIRO’s Impact Evaluation Guide.
REFERENCES:
[1] Guidelines. NHMRC. (n.d.). Retrieved February 16, 2023, from https://www.nhmrc.gov.au/guidelines
The Bree Collaborative shares completed case studies in the applicable sections of our Implementation Guide as examples of implementation. Publications consist of a narrative report and a one-pager summary.
The Bree may also publish case studies in academic journals, present them in webinars, share them on social media, or share them with interested stakeholders.
You can email case study idea to our Evaluation and Measurements Manager, Karie Nicholas, at knicholas@qualityhealth.org or you can submit your idea using the form below.