Practice Facilitation Handbook

Module 20 Appendix A

A. Empanelment Exercise

Practice Empanelment Exercise

Name:

Date:

Information on patient visits to clinic in past year

Patient Provider 1 Provider 2 Provider 3
John 1* 3 1
Lisa 1 1* 1
Nancy 2* 0 0
Lucy 1* 4 5
Samantha 1 4* 5
Timothy 2 2* 4
George 1 3 2
Michael 1 1 1*
Bianca 0 0 2*
Carl 1* 1 2

* Last provider seen

Where would you obtain these data for a practice?

 

 

Assign patients to a panel based on data above

Patient Provider 1 Provider 2 Provider 3
John      
Lisa      
Nancy      
Lucy      
Samantha      
Timothy      
George      
Michael      
Bianca      
Carl      

Return to Module 20

Page last reviewed May 2013
Internet Citation: Module 20 Appendix A. May 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod20appendixa.html