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Background: Despite the recent increase in opioid overdoses across Canada, few pharmacy-led initiatives have been implemented to address issues related to opioid prescribing in the hospital setting. Objectives: The primary objective of this study was to develop a clinical tool, intended for use by hospital pharmacists and informed by best practices from the literature, that would provide a structured approach to enhancing the safety of opioid prescribing. The secondary objective was to collect pharmacists’ opinions about the feasibility and utility of this tool. Methods: A comprehensive literature search and pharmacist focus group analysis provided content for development of a candidate clinical tool. This tool was then piloted by clinical pharmacists working on general medical and surgical units in a single hospital. Pharmacists participating in the pilot were invited to complete an online survey concerning their perceptions of the tool. Descriptive statistics were used to analyze the survey results. Results: The literature search and focus group analysis led to development of a candidate clinical tool that focused on Medication review, Optimization, Reassessment, and Education (MORE). It included key risk factors relating to opioid safety, along with suggested mitigating strategies. The MORE tool was piloted for 3 weeks by 14 clinical pharmacists, 9 of whom responded to the subsequent survey. Five respondents indicated that the clinical tool increased their ability to identify risk factors. Five respondents also noted an increase in their ability to identify possible interventions. Most respondents felt that the tool was useful and that it would be feasible to integrate it into their practice; however, they noted that a more streamlined version could improve ease of use. Conclusions: The MORE tool was well received by clinical pharmacists. Implementation of the tool into routine practice requires additional changes to improve ease of use. Suggestions for modifying and streamlining the tool will be incorporated into future versions. RESUME Contexte : Malgre l’augmentation recente des surdoses d’opioides au Canada, peu d’initiatives menees sous la houlette de pharmacies ont ete mises en place sur les enjeux potentiels lies a la prescription d’opiaces en milieu hospitalier. Objectifs : L’objectif principal de cette etude visait a elaborer un outil destine aux pharmaciens d’hopitaux, s’inspirant des meilleures pratiques rapportees dans la documentation, qui fournirait une approche structuree pour ameliorer la securite de la prescription d’opioides. L’objectif secondaire consistait a recueillir les opinions des pharmaciens sur la faisabilite et l’utilite d’un tel outil. Methode : Des recherches bibliographiques etendues ainsi qu’une analyse de groupes de discussion de pharmaciens ont fourni le contenu necessaire a l’elaboration d’un outil clinique experimental. Ensuite, cet outil a ete teste par des pharmaciens cliniciens travaillant dans des unites medicales generales et chirurgicales au sein d’un seul hopital. Les pharmaciens participant au projet pilote ont ete invites a repondre a une enquete en ligne sur leur perception de l’outil. Des statistiques descriptives ont permis d’analyser les resultats de l’enquete. Resultats : Les recherches bibliographiques et l’analyse des groupes de discussion ont debouche sur le developpement d’un outil clinique nomme MORE [pour Medication review, Optimization, Reassessment, and Education , ou Examen, optimisation, reevaluation et education aux medicaments]. Il comprenait des facteurs de risque lies a la securite des opioides ainsi que des suggestions de strategies d’attenuation. Quatorze pharmaciens cliniciens, dont neuf ont repondu a l’enquete qui a suivi, ont teste le MORE pendant trois semaines. Cinq repondants ont indique que l’outil clinique augmentait leur capacite a determiner les facteurs de risque. Cinq ont egalement note une meilleure capacite a determiner les interventions possibles. La plupart des repondants ont estime que l’outil etait utile et qu’il serait possible de l’integrer dans leur pratique; cependant, ils ont aussi note qu’une version simplifiee pourrait faciliter son utilisation. Conclusions : Les pharmaciens cliniciens ont bien accueilli l’outil MORE. Sa mise en oeuvre dans la pratique courante exige cependant des changements supplementaires pour faciliter son utilisation. Les versions a venir tiendront compte des propositions visant a le modifier et a le simplifier.