Build a recommendation plan


This module summarizes the types of recommendations that may be developed through the overdose fatality review process; provides an overview of the recommendation process, from developing to sustaining recommendations; and offers a method to track, monitor, and assess the implementation of recommendations.

Identifying Recommendations During the OFR Review

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The overdose fatality review (OFR) process is driven by an action-oriented partnership. Data comes from members representing multiple agencies. Each member gathers and provides potentially sensitive information to the team that informs the understanding of the overdose problem and potential solutions.

Successful OFRs rely on active engagement by members beyond the detailed case discussions, including formation, implementation, assessment, and continuation of prevention strategies. It is important that the OFR facilitator reinforce that recommendations can be identified and implemented through the OFR’s collaborative, data-driven, problem-solving process.

Form a Subcommittee to Develop Recommendations

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Recommendations can be diverse, and some are easier to implement than others. Planning and implementing recommendations is a very rewarding process that can have immediate and tangible results. Some recommendations maintain momentum, and others may slowly lose support. The process can be challenging when factors outside of the OFR team’s control impact progress. Creating subcommittees to focus and implement specific recommendations can maintain momentum by building sustained internal and external support for the strategy.

Implement Recommendation

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Once the subcommittee has developed a recommendation, it needs to be implemented. It is important to do so strategically. The subcommittee lead may consider sharing recommendation materials with persons not on the subcommittee for their review and feedback.

The subcommittee must develop a work plan for implementing the recommendation.

Assess and Monitor Recommendation

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Plans for assessing and monitoring recommendations need to be developed at the beginning of the initiative. Steps for regularly updating and tracking the status of recommendations include:

Giving status updates

The subcommittee lead will check regularly with subcommittee members on the status of assigned tasks and implementation.

Reporting to the overdose fatality review coordinator

Prior to each fatality review and scheduled governing committee meetings, the subcommittee lead will give updates to the overdose fatality review coordinator on how implementation is going and ongoing plans to monitor and support recommendations. The subcommittee lead would likely provide a verbal progress report during OFR case review meetings.

Monitor Recommendation

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Tracking current status of recommendation

Documenting the implementation status of the recommendation is encouraged. The overdose fatality review manager is responsible for documenting the status. The OFR coordinator, in partnership with the subcommittee monitor role, is responsible for systematically monitoring the status of recommendations. If the OFR coordinator is not involved throughout the recommendation implementation process, he or she will need to follow up with partners (for example, the subcommittee lead or monitor) to learn the status of the recommendation. The OFR coordinator will work with the OFR data manager to ensure the status of the recommendation is tracked in the OFR database. Recommendation data elements are included in the OFR Database.

Identifying Recommendations During the OFR Review

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The overdose fatality review process is driven by an action-oriented partnership. Data comes from members from multiple agencies. Each member gathers and provides potentially sensitive information to the team that informs the understanding of the overdose problem and potential solutions.

Successful OFRs rely on active engagement by members beyond the detailed case discussions, including formation, implementation, assessment, and continuation of prevention strategies. It is important that the OFR facilitator reinforce that recommendations can be identified and implemented through the OFR collaborative, data-driven, problem-solving process. Learn more about this process in Section 3C. Meeting Agenda Step 7 Formulate Recommendations.

Form Subcommittee to Develop Recommendation

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Recommendations can be diverse, and some are easier to implement than others. Planning and implementing recommendations is a very rewarding process that can have immediate and tangible results. Some recommendations maintain momentum, and others may slowly lose support. The process can be challenging when factors outside of the overdose fatality review team’s control impact progress. Creating subcommittees to focus and implement specific recommendations can maintain momentum by building sustained internal and external support for the strategy.

Implement Recommendation

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Once the subcommittee has developed the recommendation, it needs to be implemented. It is important to do so strategically. The subcommittee lead may consider sharing recommendation materials with persons not on the subcommittee for their review and feedback.

The subcommittee must develop a work plan for implementing the recommendation.

Assess Recommendation

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Plans for assessing and monitoring recommendations need to be developed at the beginning of the initiative. Steps for regularly updating and tracking the status of recommendations include the following:

Giving status updates

The subcommittee lead will check regularly with subcommittee members on the status of assigned tasks and implementation.

Reporting to the overdose fatality review team coordinator

Prior to each fatality review and scheduled governing committee meetings, the subcommittee lead will provide the OFR coordinator with status updates on the implementation as well as ongoing plans to monitor and support recommendation. The subcommittee lead will likely provide a verbal progress report during OFR case review meetings.

Monitor Recommendation

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Tracking the status of a recommendation

Documenting the implementation status of the recommendation is encouraged. The overdose fatality review manager is responsible for documenting the status. The OFR coordinator, in partnership with the subcommittee monitor role, is responsible for systematically monitoring the status of recommendations. If the OFR coordinator is not involved throughout the recommendation implementation process, he or she will need to follow up with partners (for example, the subcommittee lead or monitor) to learn the status of the recommendation. The OFR coordinator will work with the OFR data manager to ensure the status of the recommendation is tracked in the OFR database. Recommendation data elements are included in the OFR Database.

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What are the system gaps?

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What are the missed opportunities?

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What can be done to improve service delivery or intervention?

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How would this be implemented and in what settings?

OFR Problem Solving Image indicating process to identify recommendations with four questions: 1) What are the missed opportunities?, 2) What are the system gaps?, 3) What can be done to improve service delivery or intervention?, 4)How would this be implemented and in what settings?

Problem-Solving Process to Identify Recommendations

Problem solving occurs during a collaborative process that fosters accountability and transparency. Identified solutions usually involve a cross-agency response that reduces duplication and information silos. The process is best served if it prioritizes addressing system issues and making recommendations for improvement.

Subcommittees assigned to lead the development and implementation of a recommendation will want to follow the following steps:

  • 1 Identify a subcommittee lead The overdose fatality review coordinator will designate a lead for the subcommittee.
  • 2 Identify and recruit key partner agencies Subcommittee membership may include members from the governing committee, the OFR team, and outside experts.
  • 3 Host meetings Ideally, meetings will happen in person versus over the phone and at times and locations that work best for subcommittee members.
  • 4 Assign roles and responsibilities Some common formal and informal roles include lead, researcher, support, monitor, and champion.

Develop a work plan

The subcommittee is responsible for developing a work plan that:

  • Identifies key action steps needed to implement and monitor the recommendation.
  • Assigns responsibility to members and partners.
  • Determines intermediate measures of success.
  • Establishes a realistic timeline for completion.

OFR Resources

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