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.

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Page last reviewed May 2014
Page originally created May 2014
Internet Citation: Tool 3. Clinical Care Observation Guide. Content last reviewed May 2014. Agency for Healthcare Research and Quality, Rockville, MD.