Table 4.

Summary of Characteristics and Improvement Strategies of High-Performing Practices

Characteristics • Federally Qualified Health Center • Higher proportion of Medicaid or no insurance

Improvement tools and strategies • EHR prompts • Standing orders • Registries • Teams for change process • Quality improvement team meets regularly • System for empanelment • Patient experience survey to monitor performance • Patients provided with resources to manage health • Periodic measurement • Reporting practice performance • Goals and benchmarking • Customize implementation of cardiovascular disease prevention care changes to practice • Rapid-cycling, piloting, pre-testing • Design improvements for less clinician work • Designing improvements more beneficial to patients

Building blocks of high-performing primary care • Team-based care • Data-driven improvement • Patient-team partnership • Population management