Evaluating Implementation and Making Changes


Clinic change is not static. You need to visit and revisit the implementation steps over time so you can refine the process. Here are some examples different approaches to evaluating SDM in the clinic and making changes:

  • Refine in real time. Use your small team to lead “plan-do-study-act” cycles and refine implementation in real time.
  • Review progress on monthly or quarterly basis. Establish routine conversations about the DA project as part of standing clinic all-staff meetings. This keeps the SDM program in the on the table and reinforces it as part of daily clinic practice. It also engages clinicians and staff in conversations about what is working and where there is room for improvement.
  • Engage the entire clinic. Hold all staff (clinician and staff) meetings on a bi-annual basis for reflection and process refinement. These meetings are separate from the standing clinic all-staff meetings, but can be incorporated with clinic leadership committees or QI committees.

For a more robust approach, you can gather data to track your progress with the SDM/DA process. You can do this internally (within the clinic) and with the assistance through external practice facilitators.

  • Tracking in the EMR system. Work with your EMR provider to formulate a query system to track DA patient distribution and return. Your clinic can also continue to use the data collection forms and scan the paperwork into the EMR upon return of the DA.
  • Establish key personnel to track and report the aggregate data monthly or quarterly at the all-clinic staff meeting. This person can compile information from the DA collection forms and/or include the questionnaires.


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