Integrating Primary Care Practices and Community-based Resources to Manage Obesity
Tool 3. Clinical Care Observation Guide
Goal: Observe the practice workflow. Identify if there are gaps in care delivery or systems in place that facilitate obesity screening.
Potential Observations of Interest:
- What does the clinic waiting room look like?
- Are there posters highlighting the importance of healthy behaviors?
- Are there materials that patient can read to learn more or evaluate their personal health behaviors?
- Is there any space in the clinic for a patient education area?
- What happens to the patients at clinic check in?
- Are they greeted pleasantly?
- Does the front desk pass out any intake information? Is this different for new versus established patients?
- What steps does the clinic take when rooming a patient?
- Is height and weight a standard step in rooming?
- When are height and weight taken at a clinic?
- How are height and weight taken (are shoes removed?)
- Does the clinic provide counseling to patients who need assistance with health behavior change?
- Who provides this counseling—the clinician? Medical assistant? Nurse care manager? Social worker?
- When does this counseling occur?
- How does this counseling occur?
- Does the clinic seem interested in expanding its staff's ability to provide brief counseling?
- How does the clinic referral process work?
- Is there a difference between specialty care referrals and lab referrals?
- Is someone in the clinic responsible for scheduling patient referrals? Is there a designated referral coordinator or is this the medical assistant's responsibility?
- Does a patient receive a referral sheet, and is it their responsibility to make appointments?
- Who tracks to see if referrals were completed? Does anyone in the clinic make reminder calls if a referral was not completed?
- Has the clinic made any changes to their referral process in the last year?
- Does the electronic health record (if present) make referral tracking more streamlined?
- Any other observations that seem relevant to the way obese and patients at risk for obesity may be managed at the clinic.