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Table 1 Description of PACT-related activities or resources to support implementation

From: The most used and most helpful facilitators for patient-centered medical home implementation

Activity or resource Purpose or goal Example
Local (e.g., work station or parent-facility) education sessions specifically about PACT Introduce staff to the PACT model, team-based care and clarify expectations A facility or team level in-service to provide an overview of PACT, define the roles and responsibilities of different team members, and to review metrics for measuring implementation progress
Regional or national learning collaboratives about PACT Facilitate a common understanding of PACT, identify goals, and share experiences across the VHA There were a series of six regional learning collaboratives that required all medical centers to send teams to attend. Collaboratives occurred quarterly, and each covered a different topic. The attending teams were expected to take lessons back to their facilities and share them with others
Measurement tools associated with PACT to help assess the team’s performance Use of patient data to evaluate improvement benchmarks Formative evaluation and feedback
Teamlet huddles Improve communication among team members to better coordinate clinical care during a given tour of duty Brief daily meetings before clinic, or during the day, to establish a game plan for the day, clarify primary areas of responsibility, and to identify any anticipated challenges
Regular teamlet meetings (other than huddles) to discuss process/performance improvement Identify areas where performance is on track and areas where additional attention is needed Formal weekly or monthly meetings to track and trend performance-improvement activities and discuss strategies for addressing deficiencies. This may be a stand-alone meeting or a designated portion of an existing standing meeting
Information systems to provide timely data and feedback to staff on PACT activities Leverage use information technology so staff can make “real time” adjustments to processes in response to their performance The Primary Care Management Module is a suite of software tools that can be used by primary care and other teams to assign patients to teams, assign patients to practitioners, and generate reports
New approaches to scheduling Improve same day access to providers by allotting appointments for emergent issues Proactively reviewing upcoming clinic schedules to convert appointments to telephone encounters or mid-level practitioner appointments, when appropriate
Quality-improvement methods to conduct small tests of change Use established methods for implementing change, studying the impact of change, and making modifications to maximize results Plan-Do-Study-Act (PDSA) cycles for implementing process improvement in the PACT team
Disease registries Use existing or create new disease registries to evaluate care processes and outcomes, including disparities and to follow patients throughout the care trajectory Diabetes, hypertension, and congestive heart failure registries
Online toolkit of care delivery and organization tools Facilitate the peer-to-peer exchange of team- or facility-level quality-improvement tools or innovations Online compendia of quality-improvement tools developed and implemented by at least one facility, that have been vetted by a group of peers, and that address at least one priority area of PACT implementation