1. Aligning Forces for Quality Learning from Effective Ambulatory Practices (LEAP): Opportunities for Collaboration with AF4Q January 23, 2014

2. Agenda ‣ Welcome, Introductions, Roll Call Fatema Salam ‣ Providing the Context Lisa Letourneau ‣ Why should alliances pay attention to the LEAP project? ‣ About LEAP… Ed Wagner & Brian Austin ‣ Description of the project ‣ Lessons learned so far ‣ What comes next? ‣ Connecting the Dots Lisa ‣ Exploring Ways to Collaborate ‣ Next Steps Fatema

3. AF4Q, LEAP, and Super Utilizer Sites

4. Lisa Letourneau National Advisory Committee LEAP

5. Presentation to AF4Q Communities January 23 rd, 2014 Primary Care Teams: Learning from Effective Ambulatory Practices

6. Overall Project goal: Identify innovative primary care practices that can serve as models for improving efficiency and quality of the healthcare workforce.

7. LEAP Project Objectives Collect data on innovations and change processes, best practices Develop a toolkit for broad dissemination Create a learning community among exemplar sites Identify up to 30 exemplar sites

8. 31 LEAP Sites

9. Site Visit Structure On site for 3 consecutive days LEAP Team: 3 – 4 researchers/clinical experts Qualitative research expert Clinical expert Research assistant

10. Overview of Site Visit Activities Interview key leaders Clinic tour and EMR Demonstration Individual interviews with up to 5 staff members Formal staff and patient shadowing Online staff survey Photo documentation by staff Collect documents, tools Observe meetings/activities related to innovations 10

11. Site Involvement After Visits: Participation in LEAP Learning Community web site Related Emerging Leaders Program drawn from site personnel In-person meeting in Seattle Fall 2013

12. Major Findings from Site Visits: Sites have well-developed core teams surrounded by An extended team with care mgrs., pharmacists, behavioral health, etc. Sites perform planned care, population management, care management, and medication management well.. Lay-persons and flow staff play key patient care roles In most practices..

13. Dissemination Plan Code and analyze site visit and interview data Develop a web-based technical assistance program directed at primary care leaders and staff, and practice facilitators. TA will include guidance on both building teams, developing staff, and how they can be deployed to optimize care. Identify planned or ongoing PC transformation efforts willing to incorporate our TA. Evaluate the usability and impact of the TA. 13

14. Question for Today Can the LEAP NPO, sites, learning community, and/or TA program be of help to AF4Q alliances?Can the LEAP NPO, sites, learning community, and/or TA program be of help to AF4Q alliances?

15. Connecting the Dots & Next Steps