Please note some descriptions below have been taken directly from other sources. Should you require, references can be made available upon request (firstname.lastname@example.org).
Alberta AIM (Access, Improvement, Measures) helps physicians, specialists and healthcare teams see their patients sooner and reduce wait times while patients are at their appointment. Measurement is the foundation of AIM so that participants can accurately identify bottlenecks and challenges in their own practice, and better manage their patient demand with supply.
Alberta Health (AH) is the ministry that sets policy, legislation and standards for the health system in Alberta. The ministry allocates health funding and administers provincial programs such as the Alberta Health Care Insurance Plan and provides expertise on communicable disease control.
Alberta Health Services
Alberta Health Services (AHS) is a province-wide, fully integrated health system made up of skilled health professionals who promote wellness and provide healthcare to Albertans.
Alberta Medical Association
The Alberta Medical Association (AMA) stands as an advocate for its physician members, providing leadership and support for their role in the provision of quality health care.
Alberta Screening and Prevention Initiative
The Alberta Screening and Prevention (ASaP) Initiative is focused on supporting physicians and nurse practitioners to offer a screening and prevention bundle to all their patients through enhanced opportunistic and planned outreach methods, targeting patients who do not present for screening care.
The connection between the primary care provider that the patient identifies as their primary provider and the patient.
Specific to the ASaP Initiative, a bundle is the group of maneuvers selected by the provider (physician or nurse practitioner) or Primary Care Organization (e.g. Primary Care Network) that will be measured in the chart reviews; must be a minimum of five, maximum is to include all 12.
Canadian - Cardiovascular Harmonized National Guidelines Endeavour
The C-CHANGE Initiative was established to harmonize clinical practice recommendations for cardiovascular disease prevention and treatment. The initiative is part of a national cardiovascular disease prevention and chronic disease management strategy. The goals are to establish a common vision and action for cardiovascular disease and action for prevention. The ASaP Initiative aligns with the objectives of C-CHANGE.
A Chart Reviewer (CR) is a designated staff member from a Primary Care Organization (PCO - e.g. Primary Care Network) participating in the ASaP initiative. This person will work closely with their PCO’s Improvement Facilitators (IFs) to gain an understanding of each participating Primary Care Provider’s (PCP's - e.g. physicians and nurse practitioners) improvement journey. Chart Reviewers will focus on completing chart reviews at participating providers’ clinics at key points in their improvement journeys (i.e. baseline, follow-up and sustain).
Clinical Practice Guideline
Toward Optimized Practice's (TOP's) Clinical Practice Guidelines are systematically developed publications and tools based on evidence derived from journal articles and scientific publications. They are intended to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.
Clinical Process Advisor
Clinical Process Advisors (CPAs) are consultants with Toward Optimized Practice (TOP) who contribute to the improvement of health services by working with healthcare teams. Clinical Process Advisors (i) promote and support quality improvement initiatives and provide facilitation, consultation and education, (ii) help to identify, plan and implement improvement solutions and further the use of evidence-based medicine and (iii) have knowledge in adult education principles, quality improvement principles and foundations, team development and project management.
Specific to the ASaP Initiative, a Cohort refers to a group of Improvement Facilitators who follow the same training schedule and attend the same community of practice opportunities (e.g., teleconferences, webinars and social networking – i.e. Yammer) which are supported by TOP Clinical Process Advisors. Via these interactions cohort members share their learnings and support one another as they work with their improvement teams.
College of Physicians & Surgeons of Alberta
The College of Physicians & Surgeons of Alberta (CPSA) regulates the practice of medicine in Alberta.
Community Health Centre
A Community Health Centre (CHC) is a not-for-profit, publicly funded service that offers team-based, interprofessional care. Community Health Centres integrate primary care services with health promotion, illness prevention and community development initiatives. Care providers are remunerated by means other than fee-for-service.
Community of Practice
A group of people who share a common concern, set of problems, or passion about at topic, that expand their knowledge and expertise in their area of interest through ongoing interaction with each other. For ASaP the Community of Practice (CoP) members are the Improvement Facilitators (IFs) and other clinic team members involved in ASaP such as Chart Reviewers (CRs) and the Toward Optimized Practice (TOP) ASaP team. The CoP has a shared interest in quality improvement and practice screening and prevention process redesign in primary care.
Continuity of Care
The percentage of time a patient sees their own identified primary care provider with whom they have a continuous relationship rather than other primary care providers.
Electronic Medical Record
An electronic medical record (EMR) is an electronic information record of clinical encounters maintained by a healthcare provider. An electronic health record is a comprehensive collection of personal health information of a single individual entered and stored electronically.
Electronic Medical Record Knowledge Transfer Contact
An Electronic Medical Record Knowledge Transfer (EMR KT) Contact is a designated staff member from a Primary Care Organization – PCO (e.g. Primary Care Network) and/or clinic participating in the ASaP initiative. This person is someone with working knowledge of the EMRs being used at various clinics associated with the PCO and/or specific knowledge of the EMRs in their clinics. EMR KT Contacts will assist Improvement Facilitators (IFs) and Chart Reviewers (CRs) to (i) navigate participating providers’ EMRs to complete chart reviews and (ii) gain a better understanding of how providers can better utilize their EMRs to support ongoing screening and prevention processes.
Evidence Based Practice
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients to estimate the risk of benefit and harm. It is derived from high-quality research on population samples, to inform clinical decision-making.
Family Care Clinic
A Family Care Clinic (FCC) is a local, team-based primary health care delivery organization that provides individual and family-focused primary health care services tailored to meet the health needs of a community. Clinic staff members coordinate a comprehensive range of primary health care services that cover and individual’s entire lifespan. Family Care Clinics provide patients with access to the most appropriate member of a health care team who can address their health and social needs. Team members may include nurse practitioners, registered nurses, family physicians, dietitians, pharmacists, mental health professionals and other healthcare professionals.
The maintaining and restoration of health by the treatment and prevention of disease especially by trained and licensed professionals.
An Improvement Facilitator (IF) is an individual trained in process improvement methodology. The IF clarifies roles and expectations, provides structure, facilitates communication, offers ideas for solutions and assures work is completed between meetings. For the ASaP Initiative, the IF is a designated staff member from a Primary Care Organization – PCO (e.g. Primary Care Network) . Improvement Facilitators, with support from Toward Optimized Practice (TOP) Clinical Process Advisors (CPAs), guide physicians/nurse practitioners and their improvement team members through their ASaP improvement journeys. Over the course of the initiative IFs will have the opportunity to build their quality improvement skills to not only complete this work, but for future PCO quality improvement work.
Institute for Healthcare Improvement
The Institute for Healthcare Improvement (IHI) is an independent, not-for-profit organization that is a leading innovator in health and health care improvement worldwide.
Institute For Healthcare Improvement Open School
The Institute for Healthcare Improvement (IHI) Open School provides health professionals with the opportunity to learn about quality improvement and patient safety at no charge. It is an online, educational community featuring several online courses and extensive content/resources.
A specific activity or set of activities intended to bring about change in some aspect(s) of the status of the target population.
Knowledge transfer is a deliberate process of information exchange between producers and potential users of research that supports evidence-informed decision making and decision-maker informed research, ultimately for the betterment of peoples’ lives.
A statement of what a participant will know or be able to do as a result of attending an event or session.
A maneuver is a skillful or dexterous method or procedure. A clinical maneuver simply means it is applied in a clinical setting or that can impact clinical outcomes.
Model for Improvement
The Model for Improvement is a simple but powerful tool for accelerating improvement. It addresses the three fundamental questions every project should answer:
- What are we trying to accomplish?
- How will we know a change is an improvement?
- What changes can we make that could lead to an improvement?
A Nurse Practitioner (NP) is an experienced Registered Nurse (RN) with advanced education who is licensed to practice in Alberta and is regulated by a professional college. Nurse Practitioners provide high quality healthcare services that blend nursing knowledge with the ability to diagnose health conditions and treat them. They can also order tests and prescribe medications. Besides clinical care, Nurse Practitioners focus on health promotion, disease prevention, health education and counseling. Nurse Practitioners also work with families and whole communities.
Specific to the ASaP Initiative, an offer refers to an offer of a screening maneuver. An offer can be face-to-face, over the phone (if speaking with the patient/client and not leaving a message), or in personally directed mail if the offer is actionable.
Specific to the ASaP Initiative, opportunistic screening refers to one of two methods used to offer screening maneuvers to patients. Opportunistic methods use a process designed to identify patients who are due for screening when they come in for any appointment.
A key outcome in the ASaP Initiative is the change in screening offers over time. To measure this change the evaluation team calculates a percentage. The denominator is the opportunity to make an offer: that is, when a patient is due for screening care and fits the age and gender criteria for that screen. The numerator is documented evidence that the offer was made. An example: A provider has 10 patients all over the age of 18; there are 10 opportunities to offer a blood pressure test. If 8 were offered and documented, the percent of offers made would be 80%.
Specific to the ASaP Initiative, outreach screening refers to one of two methods used to offer screening maneuvers to patients. Outreach methods use a process that combs the panel for those who are due or overdue for screening, then uses that list to invite patients to come in for a screening appointment.
The number of unique, unduplicated patients that have an established relationship with a primary care provider, underscored by an implicit or explicit agreement that the identified provider will provide primary care services.
The processes for creating and maintaining patient lists.
Plan Do Study Act Cycle
A Plan Do Study Act (PDSA) cycle tests a change by planning it, trying it, observing the results and acting on what is learned. This is the scientific method, used for action-oriented learning.
The ability to use clinical skills and past experiences to rapidly identify each patient’s unique health state and diagnosis, their individual risks and benefits of potential interventions and their personal values and expectations.
Primary care is the first point of contact a person has with the health system – the point where people receive care for most of their everyday health needs. Primary care is typically provided by family physicians and nurses, dietitians, mental health professionals, pharmacists, therapists, and other healthcare professionals.
Primary Care Initiative
The Primary Care Initiative (PCI) was established by Alberta Health (AH), the Alberta Medical Association (AMA) and Alberta Health Services (AHS) to improve access to family physicians and other frontline health care providers in Alberta. The purpose of the PCI is to develop Primary Care Networks (PCNs) and to support them in meeting the objectives of the program.
Primary Care Network
A Primary Care Network (PCN) is a made-in-Alberta approach to improving access to and better coordinated care for patients across the province. In a PCN, a group of family physicians and Alberta Health Services (AHS) coordinate health services for patients. A PCN is not necessarily a bricks and mortar building – it is a network of physicians and other health providers such as nurses, dietitians and pharmacists working together to provide primary health care to patients. Currently there are 40 PCNs across Alberta.
Primary Care Organization
A Primary Care Organization (PCOs) offers a variety of approaches to community health care in Alberta. Specific to the ASaP Initiative, a Primary Care Organization (PCO) is an organization with the mandate and infrastructure to support primary care providers (e.g. physicians and nurse practitioners) with the delivery of healthcare to Albertans. Primary Care Networks and Family Care Clinics are examples of ASaP PCOs.
Primary Care Provider
A Primary Care Provider (PCP) refers to a physician or other licensed individual who delivers health care services. Specific to the ASaP Initiative, a PCP is a healthcare professional with a designated panel of patients. Physicians and Nurse Practitioners are examples of ASaP PCPs.
A series of steps that are linked together to accomplish a specific objective.
Quality Improvement (QI) refers to a systematic approach that uses specific techniques to improve quality. A ‘change’ (improvement) is combined with a ‘method' (an approach) to attain a superior outcome.
RE-AIM stands for Reach, Effectiveness, Adoption, Implementation and Maintenance. It is an evaluation framework designed to assess health interventions beyond effectiveness to include multiple criteria to better identify effect and transferability.
Samples are subsets of the population. Larger samples usually mean more precise results. Sample size usually depends on the purpose of the study, the population size from which the sample will be pulled, as well as the level of precision and the level of confidence or risk that is acceptable, and the degree of variability in the attributes being measured.
The purpose of a screening test is to diagnose a disease early before a person exhibits signs or symptoms such that measures can be introduced when the disease is easier to treat. Early intervention and disease management can improve quality of life by preventing irreversible, negative health outcomes for an individual. In the long term effective, population level screening and prevention will positively impact the larger healthcare system. While some screening procedures can be done in a family physician's office, others require patients to make a separate appointment with a different office, lab or clinic. Test results should be discussed with one's family physician. Which tests an individual needs depends on criteria such as age, gender, family history, and risk factors for certain diseases.
Strategic Clinical Network
A Strategic Clinical Network (SCN) refers to province wide teams that bring together the experiences and expertise of health care professionals, researchers, government, communities, patients and families to address the delivery of healthcare to Albertans. Each network focuses on a particular area of health with a goal to improve the patient experience, ensuring care is available when it’s needed and putting strategies in place to keep Albertans healthy. Six SCNs were operational as of March 31, 2012.
The group of individuals, usually from multiple disciplines, that drives and participates in the improvement process. Specific to the ASaP Initiative, team members are allied healthcare professionals and other support staff who work with the Primary Care Provider (PCP – e.g. physician or nurse practitioner).
Specific to the ASaP Initiative, a wave is the period of time an Improvement Facilitator (IF) is supporting a specific provider, or group of providers, through the intervention. Once that group of providers has implemented their new processes, the IF will move on to support a new group of providers in the next ‘wave’.