Glossary

Toolkit for Implementing the Chronic Care Model in an Academic Environment

Group visit: Similar to an individual planned visit but designed for groups of patients, rather than individual patient-provider appointments.

Lean principles: Derived from the Toyota Production System, lean principles in quality improvement increase efficiency of a system by eliminating wasteful in producing products or services. Lean thinking consists of: Defining value in terms of the customer; identifying the "value stream" or the specific actions necessary to produce a product or service; eliminating waste and making the process flow; allowing the customer's definition of value to pull the product or service through the process; and perfecting the process by continually removing waste.

Model for improvement: A methodology for continuously improving performance. 

Plan-Do-Study-Act Cycles: "The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change by planning it, trying it, observing the results, and acting on what is learned," according to the Institute for Healthcare Improvement.

Planned visit: An encounter with the patient initiated by the practice to focus on aspects of care that typically are not delivered during the acute care visit. 

Practice-based learning and improvement: One of six competencies a residency program must require of its residents, as outlined by the Accreditation Council for Graduate Medical Education (ACGME). "Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices." The other competencies are: medical knowledge, patient care, systems-based practice, professionalism, and interpersonal and communication skills.

Registry: An information system that tracks individual patients as well as populations of patients. 

Self-management support: An endeavor in which the healthcare team partners with patients to improve their ability to manage their conditions day to day. 

Systems-based practice: One of six competencies a residency program must require of its residents, as outlined by the Accreditation Council for Graduate Medical Education (ACGME). "Residents must demonstrate an awareness of a responsiveness to the larger context and system of health care the ability to effectively call on system resources to provide care that is of optimal value." The other competencies are: medical knowledge, patient care, practice-based learning and improvement, professionalism, and interpersonal and communication skills.

Page last reviewed January 2008
Internet Citation: Glossary: Toolkit for Implementing the Chronic Care Model in an Academic Environment. January 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/chroniccaremodel/chronicgloss.html