Team-Based Practice Transformation: Care Across the Continuum

Build a high-functioning team to enhance your patient care and strengthen your practice. This special six-hour seminar on Saturday features individual focus from practice transformation facilitators. Participants must include a team of three from each practice, including a provider, a clinical support staff person, and an administrative staff person. Includes pre-attendance preparatory materials. Separate team-based fee and registration required. Already registered for Assembly? Call 800-274-2237 to register your team today.

Presented by TransforMED in conjunction with the AAFP Assembly.

Curricular Outline and Learning Objectives:

Creating a Shared Vision of the PCMN

  • Identify needs and motivations across the internal and external care teams.
  • Develop an "Elevator Speech" vision that can be shared to facilitate PCMN relationships.

Workflow Design

  • Describe the role of work process design and clinical microsystems within performance improvement.
  • Create a process workflow related to the PCMN for their specific practice.

Transitions of Care

  • Define and discuss the value and challenges surrounding transitions of care.
  • Develop a transition of care process that addresses the six aims and seven intervention categories of Transitions of Care.

Referral Management

  • Recognize the risks associated with transitions of care and the role of referral management in reducing those risks.
  • Design a referral management process workflow with identification of roles, responsibilities and tasks.

External Sources of Care

  • Discuss the value and need for care coordination agreements when utilizing sources of care external to the practice.
  • Identify potential sources of care external to the practice.

Register Now

Tuesday, October 21 - Saturday, October 25, 2014

Walter E. Washington Convention Center

Washington, DC

Assembly Education

So many educational opportunities in one spot. See how it happens in this short 2013 Assembly video.