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1. OVERVIEW OF THE PRACTICE ENHANCEMENT PROGRAM........................................... 3 1.a Protocol............................................................................................................. 5 1.b Terms of Reference........................................................................................... 7 2.a The Assessment Process. .................................................................................14 2. Committee Members/Funders. .................................................................................13 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.h Certificate of Participation..............................................................................121 6.i PEP Resource List............................................................................................122 6.j Assessor’s Expense Claim Form. .....................................................................129