Potential Measures for Clinical-Community Relationships

Clinic/Clinician Element

 

Clinic/Clinician Element

Potential Measure A
Item Description
Title Patient difficulty in accessing primary care
Description This measure assesses whether patients have difficulty accessing routine or ongoing primary care.
Domain Accessibility (clinic/clinician)
Data source Patient/individual survey
Calculation method This measure may be reported as the percentage of patients who have difficulty accessing routine or ongoing care from a clinic/clinician. Difficulty obtaining routine or ongoing primary health care services could include: difficulty contacting a clinic/clinician, difficulty scheduling an appointment, waiting too long to obtain an appointment or follow-up visit, in-office waiting time to see clinician, and/or service not being available at the time required.
Notes This measure may be used to measure accessibility for various patient populations that may be relevant, such as patients who have visited a particular clinic or clinician, patients assigned to a provider panel by an insurer, or patients who live in a specific geographic area.

Principles for this measure may be adapted from the Canadian Institute for Health Information: Access Indicators: http://www.cihi.ca/CIHI-ext-portal/pdf/internet/PHC_POLICY_ROUTINEACCESS_EN

 

 

Potential Measure B
Item Description
Title Accessibility of clinic/clinical practices
Description This measure assesses whether clinic/clinical practices are accessible within a community.
Domain Accessibility (clinic/clinician)
Data source Audit – A standardized evaluation form may assess a clinic/clinical practice’s attributes and determine how accessible the clinic/clinical practice is.
Calculation method This measure may be assessed at the level of an individual clinic/clinician, or as the percentage of clinics or clinicians in a community that are accessible. Attributes of accessibility could include: open scheduling, open hours, proximity to various modes of transportation, etc.
Notes Similar to measure S in community resource element

 

 

Potential Measure C
Item Description
Title Clinic/clinician delivery system capability
Description This measure assesses whether clinics/clinical practices have office/administrative systems and workflow processes to support the delivery of preventive services to patients.
Domain Delivery system design (clinic/clinician)
Data source Clinic/clinician self-assessment tool
Calculation method This measure may be assessed at the level of an individual clinic/clinician, or as the percentage of clinics or clinicians in a community that have the office/administrative systems and workflow processes to support the delivery of preventive services to patients.
Notes Principles for this measure may be adapted from the Assessment of Chronic Illness Care (ACIC) Quality Improvement tool: Section 5: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1434662/

Similar to measure T in community resource element

 

 

Potential Measure D
Item Description
Title Clinic/clinician’s appropriate use of health information technology
Description This measure assesses whether clinic/clinical practices in a community use health information technology appropriately to support the delivery of clinical preventive services. Appropriate use of health information technology may be defined in terms of CMS Meaningful Use objectives, or other ways of using technology to improve quality, reduce health disparities, or engage patients and family.
Domain Information technology infrastructure (clinic/clinician)
Data source Audit – An auditor may use a standardized evaluation form to assess whether a clinic/clinical practice has access to health information technology and whether it uses the health information technology appropriately to support the delivery of clinical preventive services.
Calculation method This measure may be assessed at the level of a clinical practice or as the percentage of clinical practices within a community that use health information technology appropriately to support the delivery of clinical preventive services.
Notes Types of health information technology include: electronic health records, personal health records, health information exchanges or referral systems, and electronic resource lists. Principles for this measure may be adapted from the meaningful use objectives:
http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives

The meaning of “appropriate” use of health information technology depends on context, setting, and the particular evaluation goals of any study that uses the measure.

Similar to measure V in community resource element

 

 

Potential Measure E
Item Description
Title Financial sustainability (clinic/clinician)
Description This measure is a qualitative assessment of the financial sustainability of primary care clinics, taking into account financial performance, governance, organizational affiliations, and contractual arrangements.
Domain Organizational infrastructure (clinic/clinician)
Data source Audit - An auditor may conduct a review of relevant financial and organizational documents and gather information from clinic leaders to assess financial sustainability.
Calculation method This measure may be assessed for a particular primary care clinic, or for primary care clinics in the community as a whole. A report will be developed describing the degree to which primary care is supported by sustainable business models and governance structures.
Notes Similar to measure Y of community resource element

 

 

Potential Measure F
Item Description
Title Clinic/clinician actions to learn about community resources
Description This measure assesses the actions of clinics/clinicians within a community to learn about available preventive services offered by community resources within a community.
Domain Outreach to obtain knowledge of and familiarity with community resources (clinic/clinician)
Data source Clinic/clinician survey
Calculation method This measure may be based on specific survey items (clinician recall of telephone calls to community resource, email inquiries, website visits, etc.) or may be reported as a composite measure that combines responses to several survey items to assess the intensity of actions reported by clinicians in a community to learn about available preventive services offered by community resources.
Notes Similar to measure Q of patient element

 

 

Potential Measure G
Item Description
Title Clinician readiness to change
Description This measure assesses whether clinics/clinical practices in a community are ready to make the changes necessary to participate in clinical-community relationships.
Domain Readiness for behavior change (clinic/clinician)
Data source Clinic/clinician survey
Calculation method This measure may be assessed at the level of an individual clinic/clinician, or as the percentage of clinics or clinicians in a community that indicate willingness to participate in clinical-community relationships for prevention.
Notes This measure assumes that most clinicians are not already participating in clinical-community relationships for prevention. Principles for this measure may be adapted from Prochaska’s Transtheoretical model5.

 

 

Potential Measure H
Item Description
Title Infrastructure to maintain relationships with community resource(s)
Description This measure assesses whether clinics in a community have the infrastructure to maintain clinical-community relationships with community resource(s).
Domain Service capacity (clinic/clinician)
Data source Clinic/clinician survey
Calculation method This measure may be assessed at the level of an individual clinic/clinician, or as the percentage of clinics or clinicians in a community that have the infrastructure to maintain clinical-community relationships with community resources.
Notes Relevant infrastructure includes staffing, technology and training. Similar to measure AA of community resource element

 

 

Potential Measure I
Item Description
Title Progress through the stages of organizational change (clinic/clinician)
Description This measure assesses how well clinics/clinicians have been able to initiate and sustain organizational changes needed to support clinical community relationships.
Domain Stage of behavior change (clinic/clinician)
Data source Clinic/clinician survey
Calculation method This measure may be assessed at the level of an individual clinic/clinician, or as the percentage of clinics or clinicians in a community that are able to initiate and sustain relevant organizational changes over time.
Notes Measure should consider principles from Prochaska’s Transtheoretical model5.

Similar to measure R of patient element and BB of community resource element.

 

 

Potential Measure J
Item Description
Title Staff competency in providing preventive health services (clinic/clinician)
Description This measure assesses the level of clinical staff competency in providing relevant preventive health counseling services to patients.
Domain Training (clinic/clinician)
Data source Audit - An auditor may use a standard rubric to indicate the level of competency the staff of a clinic/clinical practice has in providing various preventive health services.
Calculation method This measure may be assessed at the level of an individual clinic/clinician, or as the percentage of clinics or clinicians in a community that have achieved competency in providing preventive health counseling to patients.
Notes This measure applies to USPSTF-recommended preventive counseling services.

Similar to measure DD of community resource element
Page last reviewed October 2013
Internet Citation: Clinic/Clinician Element. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/resources/ccrm-atlas-suppl/ccrm-atlas3-1.html