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Table of Contents

1. OVERVIEW OF THE PRACTICE ENHANCEMENT PROGRAM......................................... 3

1.a Protocol........................................................................................................... 5

1.b Terms of Reference......................................................................................... 7

2. Committee Members/Funders. ...............................................................................13

2.a The Assessment Process. ...............................................................................14

3. What The Assessor Looks For . . .. ..........................................................................16

3.a CPSS Walk-In Guidelines - April 2012. ...........................................................19

3.b PEP - Outline for Interview with Physician ....................................................25

3.c PEP Assessment Categories............................................................................26

4. Assessment Tools - Letters (GP) ............................................................................27

4.a Worksheet for Arranging Assessment (GP 2012). ..........................................28

4.b IntroLetter GP................................................................................................30

4.c Eligible Letter GP............................................................................................33

4.d Cover Letter Patient.......................................................................................35

4.e Cover Letter Physician....................................................................................36

4.f Assessor Request............................................................................................37

4.g Confirmation of Assessment...........................................................................38

4.h Final Reporting Letter - Category 1. ...............................................................39

4.i Final Reporting Letter - Category 2. ................................................................41

4.j Final Reporting Letter - Category 3.................................................................43

5. Assessment Tools - Questionaires (GP)..................................................................44

5.a Physician Pre-visit Questionnaire Q2..............................................................45

5.b Patient. ..........................................................................................................50

5.c PRACTICE ENHANCEMENT PROGRAM..............................................................54

5.d Physical Facilities & Practice Organization.....................................................55

5.e Post Assessment Questionaire Q-3.................................................................72

5.f Assessee Feedback Questionaire Q6. ..............................................................78

6. FORMS & TOOLS USED FOR GP ASSESSMENTS........................................................79

6.a Assessment Package Outline..........................................................................80

6.b Assessment - Chart Review Form...................................................................81

6.c Chart Review Checklist - CR-1. .......................................................................84

6.d Office Assessment Checklist R-2.....................................................................90

6.e PEP - Outline for Interview with Physician ....................................................97

6.f.i MSB Numerical..............................................................................................98

6.f.ii

MSB Numeric Explanation. ...........................................................................99

6.g The Final Report - Description......................................................................102

6.g.i Final Report Samples..................................................................................116

6.h Certificate of Participation............................................................................163

6.i PEP Resource List..........................................................................................164

6.j Assessor’s Expense Claim Form. ...................................................................171