EvidenceNOW Tools for Change for Practice Facilitators

The EvidenceNOW Model for supporting primary care practice improvement originated from a multiyear AHRQ grant initiative designed to advance the adoption of clinical and organizational evidence. EvidenceNOW grantees used practice facilitators to help small- and medium-sized practices implement evidence on heart health. Through EvidenceNOW and other QI initiatives, AHRQ has identified resources that can help practices implement evidence.

One set of resources is part of the EvidenceNOW Key Driver Diagram. They can be used by practice leaders, clinicians, and other practice staff, as well as by practice facilitators and other QI professionals.

The resources on this page are specifically for practice facilitators and QI professionals working with primary care practices. The resources are organized in three sections:

  • Engaging Practices covers how a practice facilitator begins working with a practice.
  • Quality Improvement Work covers the nuts and bolts of working with practices to improve quality of care, from the basics of forming QI teams within practices, to effective use electronic health records (EHRs), to panel management and patient engagement.
  • Administrative Tools covers ways of tracking practices’ progress and documenting facilitators’ work.

Engaging Practices

Introducing a Practice to Facilitation
This resource explains the concept of primary care practice facilitation to improve health care quality and how to help practices understand the purpose and functions of a practice facilitator.

Assessing Practice Readiness for Change
This resource outlines criteria and signs that primary care practices are ready to work with practice facilitators and engage in QI projects.

Conducting a Kickoff Meeting
This resource explains how to begin practice facilitation with a successful meeting to kick off a QI project.

Kick-Off Visit Checklist
This resource presents a checklist to help practice facilitators prepare for, conduct, and follow up after a meeting to kick off a QI project in primary care.

Implementing Heart Health Practice Self-Assessment
This toolkit is for facilitators to help primary care practices implement the ABCS of heart health and create a supportive practice environment for quality improvement. It contains 15 different checklists and strategies.

Quality Improvement Work

Creating Quality Improvement Teams and QI Plans
This resource explains the fundamentals of building and working with QI teams in primary care practices and developing QI plans.

Working with and Supporting Practice Leaders
This resource discusses ways to engage primary care practice leadership to implement evidence-based QI efforts.

Running Effective Meetings and Creating Capacity for Practices to Run Effective Meetings
This resource provides information on the principles of effective meetings and the use of meetings in primary care QI efforts.

Responses to Common Practice Objections to Changes Needed to Implement Evidence
This resource helps facilitators anticipate the potential objections of primary care practices to making changes to implement evidence. It offers ways to respond and help practices maintain forward momentum on QI efforts.

Helping Practices Optimize EHRs for Patient-Centered Medical Home Transformation and Quality Improvement
This resource introduces ways electronic health records (EHRs) can support QI in primary care practices.

Quality Improvement Change Assessment (QICA)
This tool assesses primary care practices’ capacity to make changes needed to implement heart health evidence. The QICA identifies areas for improvement, and when completed at regular intervals, tracks practice transformation progress.

Implementing Care Teams
This resource describes the rationale for primary care practices to switch to care teams, describes how teams function, and provides implementation tips.

Facilitating Panel Management
This resource explains the basics of implementing panel management, whereby patients are assigned to care teams that take responsibility for ensuring patients receive care that is consistent with current evidence.

Improving Self-Management Support and Engaging Patients in Care and Practice Improvement Topics
This resource discusses how primary care teams provide self-management support to patients with chronic conditions.

Self-Management Support Strategies for Improving CVD Risk Factors—Practice Engagement!
This presentation explains key principles of effective self-management support (SMS) and the evidence behind SMS for improving heart health. It also includes strategies to implement SMS throughout primary care practices.

ABCS Toolkit for the Practice Facilitator
This toolkit introduces the ABCS of heart health and provides checklists, action plans, and other instructions to guide primary care practices to implement evidence-based guidelines, transform health care delivery, and improve patients’ heart health.

Administrative Tools

Documenting Your Work with Practices
This resource discusses how practice facilitators can document primary care practices’ progress on QI projects and keep track of activities across multiple organizations.

Clinic Intervention Tracking Sheet
This QI intervention tracking sheet helps primary care practices and practice facilitators assess and monitor efforts to improve heart health outcomes. The worksheet can also be adapted for other QI efforts.

Practice Progress Notes Template
This reporting template can be used by practice facilitators to track progress on goals and measures for QI projects. It can help facilitators plan their own work and keep the primary care practice team focused on QI activities.

Page last reviewed July 2019
Page originally created October 2016
Internet Citation: EvidenceNOW Tools for Change for Practice Facilitators. Content last reviewed July 2019. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/evidencenow/tools/facilitation/index.html
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