Practice Optimization and Operations


ED Hospitalization and Follow-up

ED Hospital Follow-up Letter by St. Mary's Family Medicine
ED Hospital Follow-up P&P by Grand River Primary Care
ED Hospital Follow-up Template
ED Hospital Follow-up Workflow Example by Telluride Medical Center
Reducing ED Use Toolkit


Empanelment Implementation Guide by CPC

Group Visits

Diabetes Group Visit Checklist
Diabetic Clinic Evaluation


Huddle Sheet
Huddle Strategies and Checkllist
Huddles Improve Office Efficiency in Mere Minutes

Job Descriptions

Health Tech and Medical Assistant
MA Care Manager and Care Coordinator

Patient Surveys

Patient Satisfaction Survey

PDSAs and Workflows

Assessing, Diagnosing and Treating Your Outpatient Primary Care Practice
Chronic Medication List
Improving your practice
Integrating Chronic Care and Business Strategies in the Safety Net
PDSA Example by Grand Mountain Primary Care
PDSA Example by Mercy Family Medicine
PDSA Example by Uncompahgre Medical Center
Quality Improvement Strategy


Advancing the practice of patient- and family-centered care in primary care
Creating Patient and Family Advisory Councils in CPC Practices
Guide for Developing a Community-Based Patient Safety Advisory Council
PFAC Policy and Procedure Example by Western Valley Family Practice
Providing New Opportunities for Collaboration

Practice Optimization and Operations

ADAPT-Survey Materials
Checklist for Choosing an EHR
Continuous Quality Improvement
Ensuring Healthcare Improvements Stick by IHI
GROW Pathway Planning Worksheet
Guide to Better Office Visits- English
Guide to Better Office Visits- Spanish
IHI Improving Joy in Work Framework

QI Meetings

IHI Innovation System
IHI Tool: Visual Management Board
Meeting Agenda Example by Colorado West Dermatology
Meeting Agenda Example by Fruita Family Medicine
Meeting Agenda Example by Mercy Family Medicine
Meeting Minutes Example by Grand River Primary Care
Meeting Minutes Example by Mercy Family Medicine
Team Meeting Agenda Template

Remote Access

Applying Behavior Change Principles
Business Impact of Effective Remote Care Management
Care Innovations Guide
Cost Control for Chronic Conditions
Improve Your MA Star Ratings
Successful Remote Care Management Implementations

Spread and Sustainability

Eagle Valley Family Practice: Spread and Sustainability Plan
Practice Sustainability Monitor
Spread and Sustainability Plan by Peak Professionals
Spread Checklist & Plan Template


Business Continuity Manual
Engaged Leadership - Resources for Leaders
Envisioning New Roles for Medical Assistants
Forming the Team
Foundations Elevator Speech Example by Southwest Medical Group
Implementation Guide Elevating Role Medical Clinical Assistant
Model for Accelerating Improvement
Team Based Care Assessment
Team Charter Template by HealthVisions Delmarva
Team-Based Healing Relationships


Addressing Cost-Quality-Access with Innovative Telehealth Technology
CMS Telehealth Factsheet

Using Technology and Data

Article, AAFP Guide to Performance Measure
Diabetes Registry Example
Optimizing Health Information Technology for Patient-Centered Medical Homes
Using Computerized Registries in Chronic Care
Using Health Information Technology to Support Quality Improvement in Primary Care

Value-Based Payment

The Limits and Future of Quality-Based Compensation