Next Steps Robert A. Gabbay, MD, PhD Professor of Medicine, Penn State College of Medicine

Until we meet again… Use your practice facilitator as a resource. Meet with and call Patty/Sharon: Pick a date today! Reflect on and respond to their feedback Continue (or start) holding weekly team meetings. Develop a plan to collect any data you don’t have or correct any data you know is wrong. Identify diabetes patients overdue for visits and reach out to them to schedule a visit and provide follow-up care.

Until we meet again… Continue implementing critical changes on monthly reporting form. Population alert Template/flow sheet Standing orders Huddles Planned care at every visit Patient report cards Patient self-mgmt goals Risk assessment at every visit Follow-up care for high-risk

Until we meet again… ▪ March 28 Show significant and sustained improvement in at least 1 outcome measure and 3 process measures. Keep on reporting PDSAs, data, status reports. Participate in webinars: 12pm-1pm Feb. 21 ▪ March 28 April date tba Tell us what you need!

Monthly Report Due Dates February 5 March 5 April 5 May 6 June 5

Learning Session #4 South Central Northwest May 9: 5-9pm at PSU College of Medicine, Hershey Northwest May 16: 5-9pm at Cross Creek Resort, Titusville

Practice Facilitators Northwest Patricia J. Stubber, MBA Executive Director Northwest PA AHEC 8425 Peach Street Erie, PA 16509-4788 814-217-6029 (phone) 814-594-4740 (cell) 814-864-4077 (fax) pstubber@nwpaahec.org South Central Sharon M. Adams RN, BA Executive Director Southcentral PA AHEC PO Box 509 Carrolltown, PA 15722 814-344-2222 (phone) 814-344-2221 (fax) sadams@scpa-ahec.org Web: www.paspread.com Email: paspread@hmc.psu.edu