Tools and Resources for Clinical Practice

These tools and resources were developed with the primary care clinicians and teams in mind and can help facilitate delivery of high-quality care.

Resources and tools in this section fall into nine categories:

• Providing Evidence
• Utilizing Health IT
• Facilitating Shared Decision Making
• Addressing Health Literacy
• Supporting Self-Management
• Improving Your Practice
• Improving Quality of Care
• Using Practice Facilitation

Providing Evidence

• Prevention TaskForce is a free app for clinicians to search and browse U.S. Preventive Services Task Force (USPSTF) recommendations on the Web, on a PDA, or on a mobile device to bring recommendations, clinical considerations, and selected practice tools to the point of care.
• The Effective Health Care Program translates comparative effectiveness reviews and research reports into short, easy-to-read summaries for clinicians and their patients. The Program most recently produced Lung Cancer Screening Tools for patients and clinicians to facilitate discussions about lung cancer screening with low-dose computed tomography (LDCT).

Utilizing Health IT

• Guide to Reducing Unintended Consequences of Electronic Health Records is an online resource designed to help you and your organization anticipate, avoid, and address problems that can occur when implementing and using an electronic health record (EHR). The Guide provides practical, troubleshooting knowledge, and resources.
• Core Functionality in Pediatric Electronic Health Records EHRs examines features needed in pediatric electronic health record (EHR) systems to ensure quality care for children.
• Examining the Relationship Between Health IT and Ambulatory Care Workflow Redesign (PDF, 3.4 MB) documents how workflow changed in six primary and specialty care medical offices after health IT systems were implemented.
• Patient-Reported Health IT and Workflow (PDF, 3.9 MB) documents workflow impacts of applications that allow patients to share information with primary care providers electronically.
• The Using Health Information Technology to Support Quality Improvement in Primary Care (PDF, 795 KB) white paper describes factors that support the use of health information technology (IT) for quality improvement (QI) in primary care, discusses exemplary cases, and makes recommendations to support and increase the use of health IT to improve the quality of health care delivery and population health outcomes. It is designed for use by practice facilitators and other quality improvement "agents" to help them optimize practices' health IT capabilities for QI purposes (in addition to the use of health IT for clinical care).
• Health IT-Enabled Care Coordination and Redesign in Tennessee (PDF, 2.1 MB) highlights opportunities to improve the impact of health IT on care coordination activities in primary care.

Facilitating Shared Decision Making

• Shared decision making explores and compares the benefits, harms, and risks of each option through meaningful dialogue about what matters most to the patient. The SHARE, A 5-Step Process for Shared Decision Making are a collection of references guides, posters, and other resources, all designed to support implementation of SHARE.

Addressing Health Literacy

• The AHRQ Health Literacy Universal Precautions Toolkit – 2nd edition can help primary care practices reduce the complexity of health care, increase patient understanding of health information, and enhance support for patients of all health literacy levels. Also available are the companion guide, Implementing the AHRQ Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Care Practices, and a crosswalk showing how implementing health literacy tools can help meet standards for patient-centered medical home certification or recognition or meet Accreditation Canada standards.
• Clearly stating medication instructions improves patient understanding and possibly reduces errors while improving adherence. Explicit and Standardized Prescription Medicine Instructions offers tested instructions for pills simplify complex medicine regimens by using standard time periods for administration. These instructions have also been translated into Chinese, Korean, Russian, Spanish, and Vietnamese.
• How to Create a Pill Card helps users create an easy-to-use "pill card" for anyone who has a hard time keeping track of their medicines. Step-by-step instructions, sample clip art, and suggestions for design and use will help to customize a reminder card.

Supporting Self-Management

• Self-Management Support Resource Library was developed to help primary care team members learn about self-management support and develop their self-management support skills in working with chronically ill patients. Videos address the what, why, and how of self-management support to help practices improve this important aspect of comprehensive primary care.

• The Patient Self-Management Support of Chronic Conditions: Framework for Clinicians Seeking Recertification Credit (MOC Part IV & PI-CME) provides a free, self-contained framework for clinicians to design their own QI project.

Improving Your Practice

• Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff provides a framework and practical evidenced-based guidance for primary care teams to adopt and successfully implement health assessments in primary care practices.
• There are also modules for clinicians to earn board-specific recertification--Health Assessment Recertification Project for Diversely Trained Clinicians (MOC Part IV & PA-QI)--that provides easy-to-complete quality improvement activity to help clinicians improve health assessment documentation in medical records (electronic or paper-based).

Improving Quality of Care

• Errors during transitions of care from one ambulatory care facility clinician to another are especially vulnerable to patient safety errors are due, in part, to a lack of effective communication and patient engagement in shared decisionmaking AHRQ’s Toolkit to Engage High-Risk Patients In Safe Transitions Across Ambulatory Settings is designed to help staff actively engage patients and their care partners during transitions.
• Confidential feedback reporting is widely considered to be a precursor to and a foundation for performance improvement. However, to enable change, the physician responsible for and capable of change must receive, understand, and act on the information. Confidential Physician Feedback Reports: Designing for Optimal Impact on Performance informs developers of feedback reports about evidence-based strategies to consider when developing or refining a feedback reporting system.
• Will It Work Here? A Decision Maker's Guide to Adopting Innovations can help you determine if an innovation would be a good fit—or an appropriate stretch—for your health care organization by asking a series of questions. It links users to actionable web-based tools and presents case studies that illustrate how other organizations have addressed these questions.
• Improving Your Laboratory Testing Process is a newly revised AHRQ toolkit that provides a step-by-step guide on how to improve the safety and accuracy of the diagnostic testing process in primary care settings. The guide, an update of a 2013 AHRQ toolkit, can help primary care teams assess how laboratory tests are managed and how the process flows from ordering to follow-up. Approximately 40 percent of medical office visits involve diagnostic testing, with a total of more than 2 billion lab tests performed annually in the United States, predominantly in ambulatory care settings. The majority of errors that occur in the laboratory testing process are related to communication breakdowns.

Using Practice Facilitation

• How a Practice Facilitator Can Support Your Practice (PDF, 111.5 KB) provides tips and techniques for primary care practices interested in getting started with quality improvement activities and describes the benefits of working with a practice facilitator (quality improvement coach).