Chronic care

QualityTools

DiabetesIQ 11/15/11

DiabetesIQ is a mobile application for patients and nonpatients to learn about diabetes and ways to manage it. Through quizzes and games, users can compete with others in their knowledge level of diabetes. Users can track glucose levels, blood pressure, weight, and exercise and share the information with health care professionals or caregivers.

Registration and download of the application is free.

Heart Failure Toolkit for Providers 11/15/11

This toolkit offers a comprehensive set of resources to assist providers in managing heart failure (HF). It focuses on several key areas in the management of HF with downloadable documents. The tools are organized by their source: Veterans Affairs (VA), non-VA, or other.

Tools are available in the following categories:

  • HF practice guidelines
  • HF clinical pathways
  • HF clinical algorithms
  • HF screening forms and chart reminders
  • HF admission...
Interactive Asthma Action Plan (iAAP) 10/26/11

The interactive Asthma Action Plan (iAAP) is a computerized clinical decision support tool for health care providers who treat asthma patients. It helps patients and physicians manage and prevent asthma symptoms, while providing information to the patient’s health care team. The iAAP program creates patient-specific treatment plans, which are available in English and Spanish.

The iAAP is available via a Web-based kiosk or can be downloaded to run either on a desktop or for...

Tobacco-Dependence Treatment Toolkit 09/14/11

The Tobacco-Dependence Toolkit provides a practical approach to treating tobacco dependence effectively. The toolkit approaches tobacco dependence as a severe chronic illness—like asthma—with exacerbations and remissions, and is based on the premise that chest physicians must be as actively and professionally engaged in treating tobacco dependence as they are with asthma. Effective tools, treatment algorithms, and strategies to obtain compensation for tobacco-dependence treatment services...

Health Information Technology Toolkit for Home Health Agencies 09/01/11

This toolkit for home health agencies, private duty nursing services, home-based hospices, and other organizations providing health care services, provides resources and tools to plan and implement health information technology in the home health location.

Each tool includes a statement of purpose, instructions for use of the tool, and tool structure. The toolkit consists of seven stages categorized into three main sections:

  • Section 1: Adopt
    • Assess
    • ...
Tools for Building Clinic–Community Partnerships To Support Chronic Disease Control and Prevention 07/21/11

These tools are organized around the Framework for Building Clinic–Community Partnerships to Support Chronic Disease Control and Prevention. This framework suggests that partnerships, specifically clinic– community partnerships, are key to building community support for chronic disease care and management. It outlines how essential partnership characteristics build capacity necessary to achieve specified intermediate and long-term outcomes.

Although developed with diabetes in...

Community Health Assessment aNd Group Evaluation (CHANGE): Building a Foundation of Knowledge to Prioritize Community Needs 07/21/11

Community Health Assessment aNd Group Evaluation (CHANGE) is a data collection tool and
planning resource for community members who want to improve the health of their community. This tool walks community team members through the assessment process and helps define and prioritize possible areas of improvement.

To use the CHANGE tool, an Action Guide is provided, which walks through the step-by-step process for completing the tool. In addition, this Action Guide provides resources...

Reducing Care Fragmentation: A Toolkit For Coordinating Care 07/06/11

This toolkit has been designed for patient-centered medical homes aiming to transform how their clinics manage patient referrals and transitions, and its goal is to provide clinical practice resources to support coordinated care. The toolkit introduces four key concepts for enabling change, and offers activities, tools, and case studies to support their implementation.

The toolkit is divided into the following sections:

  • Introduction
  • The care coordination...
A Guide to Group Visits for Chronic Conditions Affected by Overweight and Obesity 07/05/11

Group medical visits for conditions caused or affected by poor fitness habits offer an opportunity to provide patients with accurate information on nutrition, physical activity, and emotional well-being. This guide provides physicians with detailed information about group visits and includes instructions, tips, and checklists to assist in preparing, conducting, and billing for group visits.

In addition, the guide includes samples of the following materials:

  • ...
National Commission on Correctional Health Care: Nursing Chronic Disease Flowsheet 06/07/11

This flowsheet can help correctional health care professionals effectively manage diseases commonly found in jails, prisons, and juvenile confinement facilities. It is designed to be used for a nursing chronic disease visit that occurs between a clinician’s chronic disease visits. The form allows tracking of vital signs, nursing history, and data (e.g., labs, medications) to be viewed over time to assess clinical trends.

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