Practical Tools for Primary Care Practice

• For Clinicians in Primary Care Practice
• For Practice-Improvement Organizations and Learning Communities
• For Primary Care Researchers and Evaluators

For Clinicians in Primary Care Practice

• Tools & Toolkits

Tools & Toolkits

• TeamSTEPPS for Office-Based Care: The office-based version of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) adapts the core concepts of 20 years of evidence in the application of teamwork principles to building high-functioning teams with examples, discussions, videos, and exercises tailored to the ambulatory care environment.
   
• Prevention TaskForce: Prevention TaskForce is a free app for clinicians to search and browse U.S. Preventive Services Task Force recommendations on the Web, on a PDA, or on a mobile device, to bring recommendations, clinical considerations, and selected practice tools to the point of care.
   
• SHARE, A 5-Step Process for Shared Decision Making The SHARE Approach is a five-step process that includes exploring and comparing the benefits, harms, and risks of each option through meaningful dialogue about what matters most to the patient. The SHARE Approach tools are a collection of references guides, posters, and other resources, all designed to support implementation of SHARE.
   
• The AHRQ Health Literacy Universal Precautions Toolkit – 2nd edition and the companion guide, Implementing the AHRQ Health Literacy Universal Precautions Toolkit: Practical Ideas for Primary Car Practices: These tools help primary care practices reduce complexity and increase patient understanding of health informationto support patients of all health literacy levels. A crosswalk shows how implementing health literacy tools can help meet standards for patient-centered medical home certification or recognition or meet Accreditation Canada standards.
   
• Workflow Assessment for Health IT: This toolkit is designed for people and organizations involved in the planning, design, implementation, and use of health information technology in ambulatory care to help reorganize and improve clinical and administrative workflow.
   
• How a Practice Facilitator Can Support Your Practice: This document provides tips and techniques for primary care practices getting started with quality improvement activities and describes the benefits of working with a practice facilitator (quality improvement coach).
   
• Integration Playbook: This Web-based resource complete and concise set of instructions on implementing integration of behavioral health and primary care, applicable to any primary care practice context, no matter how large or small the practice. Tips and examples can also easily translate the playbook to medical specialties.
   
• Explicit and Standardized Prescription Medicine Instructions: To improve patients’ understanding and possibly reduce errors while improving adherence, these tested instructions use standard time periods to simplify complex medicine regimens, and have been translated into Chinese, Korean, Russian, Spanish, and Vietnamese.
   
• Toolset for E-Prescribing Implementation in Physician Offices: This toolset provides ambulatory care practices resources to implement e-prescribing successfully.
   
• How to Create a Pill Card: This guide helps users customize an easy-to-use "pill card" to keep track of medicine schedules, using step-by-step instructions, sample clip art, and suggestions for design and use.
   
• The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Ambulatory Care Improvement Guide: This survey helps health care providers better understand the kind of organizational environment that supports positive patient experience, the steps they can take to apply established improvement methods to patient experience, and ways to use the survey results to identify performance problems and causes. It includes more than a dozen improvement strategies organized by CAHPS survey topics.
   
• Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff: This guide provides a framework and practical evidenced-based guidance for primary care teams to adopt and successfully implement health assessments in primary care practices.
  • Modules for clinicians to earn board-specific recertification are included in the Health Assessment Recertification Project for Diversely Trained Clinicians (MOC Part IV & PA-QI)
     
• Self-Management Support Resource Library and Videos: This library helps primary care team members learn about and develop their self-management support skills in working with chronically ill patients. Videos address the what, why, and how of self-management support to help practices improve comprehensive primary care.
  • Patient Self-Management Support of Chronic Conditions: Framework for Clinicians Seeking Recertification Credit (MOC Part IV & PI-CME)

For Practice-Improvement Organizations and Learning Communities

• Tools & Guides

Tools & Guides

Practice Facilitation

• Primary Care Practice Facilitation Curriculum: This curriculum is designed to train new practice facilitators (also known as practice coaches, quality improvement coaches, or practice enhancement assistants) as they learn how to support meaningful improvement in primary care practices, using an evidence-based approach to quality improvement.
   
• A How-To Guide on Developing and Running a Practice Facilitation Program: This guide is for organizations starting a practice facilitation program with primary care practices on quality improvement activities, with an emphasis on primary care redesign and transformation.

Quality Improvement

• Confidential Physician Feedback Reports: Designing for Optimal Impact on Performance: This guide informs developers of feedback reports—widely considered a precursor to and foundation for performance improvement—on evidence-based strategies to consider when developing or refining a feedback reporting system.
   
• Will It Work Here? A Decisionmaker's Guide to Adopting Innovations can help you determine if an innovation would be a good fit—or an appropriate stretch—for your health care organization with a series of questions. It links users to actionable Web-based tools and presents case studies that illustrate how other organizations have addressed these questions.
   
• Using Health Information Technology to Support Quality Improvement in Primary Care: This white paper describes factors that support the use of health information technology (IT) for quality improvement (QI) in primary care, discusses exemplary cases, and makes recommendations to support and increase the use of health IT to improve the quality of health care delivery and population health outcomes. It is designed for use by practice facilitators and other quality improvement “agents” to help them optimize practices’ health IT capabilities for QI purposes (in addition to the use of health IT for clinical care).
   
• Improving Your Office Testing Process A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement provides information and resources to help physicians' offices, clinics, and other ambulatory care facilities assess and improve the testing process in their offices.

For Primary Care Researchers & Evaluators

• Tools & Guides
• Data Collection

Tools & Guides

Patient-Centered Medical Home & Primary Care Transformation

• The Medical Home Index-Revised Short Form: A subset of the Medical Home Index, this validated self-assessment and classification tool is designed to translate the broad indicators defining the medical home into observable, tangible behaviors and processes of care within any office setting.
   
• Patient-Centered Medical Home Research Methods Series: Expanding the Toolbox: Methods to Study and Refine Patient-Centered Medical Home Models: This series of briefs introduces methods or approaches that have the potential to expand and refine understanding of the Patient-Centered Medical Home as a complex health care intervention and innovation.
   
• A Guide to Real-World Evaluations of Primary Care Interventions: Some Practical Advice: This guide presents practical steps for designing an evaluation of a primary care intervention. It answers the questions: Do I need an evaluation? What do I need for an evaluation? How do I plan an evaluation? How do I conduct an evaluation and what questions will it answer? How can I use the findings? What resources are available to help me?
   
• Estimating the Costs of Transforming Primary Care: A Practice Guide and Synthesis Report: This guide, based on the experiences and lessons learned from 15 AHRQ  grants, lists the key steps for analyzing the costs of a primary care transformation effort, reviews the range of methodological options, and describes key considerations for each method.
   
• Using Implementation Research to Guide Adaptation, Implementation, and Dissemination of Patient-Centered Medical Home Models: This brief focuses on using implementation research methods in studies of patient-centered medical home models.

Data Collection

Integrating Behavioral Health and Primary Care

• Lexicon for Behavioral Health and Primary Care Integration: The Lexicon is a set of concepts and definitions for behavioral health and primary care integration.
   
• Atlas of Integrated Behavioral Health Care Quality Measures: This atlas aims to support the field of integrated behavioral health care measurement by presenting a framework for understanding measurement of integrated care, providing a list of existing measures relevant to integrated behavioral health care, and organizing the measures by the framework and by user goals to facilitate selection of measures.

Patient Experience

• Clinician and Group Survey of the Consumer Assessment of Healthcare Providers and Systems: This survey assesses both adult and pediatric patients' experiences with health care providers and staff in doctors' offices. Survey results can be used to improve care provided by individual providers, sites of care, medical groups, or provider networks and to equip consumers with information to choose physicians and other health care providers, physician practices, or medical groups. Users can also add supplemental items to customize their questionnaires.

Research

• Practice-Based Research Networks (PBRNs): are “laboratories” for conducting primary care research. They draw on practicing clinicians’ experience and insight to identify and frame research questions whose answers can improve the practice of primary care. By linking these questions with rigorous research methods, Practice-Based Research Networks  produce research findings that are immediately relevant to the clinician and, in theory, more easily assimilated into everyday practice.