Quality Care Tools
Planned Care Teams
Planned care visits provide an efficient and positive patient experience because care is designed to meet specific patient needs and respond to individual patient preferences. This approach can be used for preventive care, chronic care, and transition-of-care visits.
Designate Your Planned Care Team(1 page PDF) is a tool you can use to identify the essential tasks for each phase of a planned care visit (i.e., pre-visit, visit, post-visit, and between-visit). The planned care team’s work is organized around these tasks, so you need to specify the team member(s) responsible for performing each task. Also note any needed resources and/or training.
Practice improvement often requires changes to existing processes. When you’re ready to make a change in your practice, start by developing a goal statement. Goals are most useful when they are time-specific and measurable, and they should be developed with a specific process or patient population in mind. Use the Develop a Goal Statement(1 page PDF) worksheet to help your care team create a realistic, achievable plan for change.
Plan-Do-Study-Act (PDSA) Cycle
You know that meaningful, lasting change doesn’t happen overnight. It’s also true that instituting a change can result in outcomes you didn’t anticipate. Plan-Do-Study-Act is a methodology that allows you to test proposed changes on a small scale before implementing them for your whole practice. Through repeated testing and refinement, you’ll learn what works best in your practice while limiting unwanted outcomes. Use the PDSA Planning Worksheet(1 page PDF) to prepare for the next change cycle in your practice.
Supported by an educational grant to the American Academy of Family Physicians from GlaxoSmithKline.
Install a System to Collect Data
Set up a project team, identify measures and create a patient registry.
Assemble a Project Team
Your team will help you define core measures, determine how to collect data and define what changes need to be made to start your project.
Select Core Measures
Start with just a few measures for the most common conditions in your practice.
Set Up a Patient Registry
This database allows you and your care team to manage patients who have chronic diseases proactively.
Use the System to Improve Care
Once the data-collection system is in place, analysis should only take one to two hours per month.
Assemble a Project Team
As with the data collection step, the step that includes analyzing the data and setting improvement goals relies on a high-functioning team.
Data Analysis: Data Collection to Improve Care
First, get the data into a format that facilitates group review and discussion. Then, figure out what the data are telling you.
Check for Change
Recheck the data to see if there's been improvement. While you're at it, submit the data for any available quality improvement cash bonuses.
Join a free collaborative online network committed to practice transformation. Learn more about Delta-Exchange.
This Patient-Centered Medical Home section of the AAFP web site was supported in part by a grant from Merck & Co.