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Our funding for updating this website ended in 2011, but the resources we developed are still helping clinical practices from around the world to transform the care they provide to better serve patients with chronic illness. Please visit our home page to learn more—or check out our more recent tools and resources at:


Integrating Chronic Care and Business Strategies in the Safety Net: Toolkit

The practice changes described in “Integrating Chronic Care and Business Strategies in the Safety Net” are divided into four main phases:  getting started; assess data and set priorities for improvement; redesign care and business systems; and continuously improve performance and work to make changes sustainable.  Although it is clear that changes need to be made at all levels of the organization to support this work, the tools presented here generally focus on the physician practice level.
The toolkit includes:
SEQUENCING:  the specific practice changes involved in Chronic Care Model implementation presented in a step-by-step fashion;
INTEGRATION OF BUSINESS STRATEGIES:  potential financial and operational barriers to quality improvement described;
TOOLS:  contains more than 60 hands-on resources created by leading organizations for quality improvement initiatives organized by key change; and
EXAMPLE STORIES:  clinical practices that have made their quality improvement efforts pay talk about how they did it.
Although you are welcome to distribute this document freely, print copies are not available.  The toolkit was designed in electronic format.  During the associated intervention, practice teams found it easiest to search the content and find the tools online rather than in print.  We encourage use of the original electronic format because this is the most navigable form, allowing for customization.
This toolkit is intended to provide the resources and structure for coaches to use in helping teams in a wide variety of settings improve clinical quality.  Modifications and tailoring for your setting may be necessary.  Please note that many of the tools presented here are copyrighted and cannot be modified without permission from the original author(s)
Suggested citation: Integrating Chronic Care and Business Strategies in the Safety Net. (Prepared by Group Health’s MacColl Institute for Healthcare Innovation, in partnership with RAND and the California Health Care Safety Net Institute, under Contract No./Assignment No: HHSA2902006000171). AHRQ Publication No. 08-0104-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2008.