Organized, Evidence-Based Care: Behavioral Health Integration is an implementation guide from our Safety Net Medical Home Initiative. It provides guidance and tools a primary care practice can use to develop a vision for integrated care and a customized implementation plan reflective of its goals and resources.
A tool for tracking and assessing chronic illness care in prison (ACIC-P).
"A tool for tracking and assessing chronic illness care in prison (ACIC-P).": Chronic disease care is being transformed in correctional settings, given an aging inmate population, ongoing quality improvement efforts, litigation, and rising costs.
New Roles for RNs in Primary Care: LEAP Webinar Series #6
The role of registered nurses in primary care is undergoing pressures from expanded MA roles and from the cost cutting efforts of practices as they try to stay competitive financially. "New Roles for RNs in Primary Care" was recorded in May 2014, and featured speakers from LEAP sites EOMA, Harvard Vanguard, and Martin's Point.
New Roles for Lay People in Primary Care: LEAP Webinar Series #5
With pressure to be more efficient and to introduce new types of interventions into care, practices are creating new roles for existing clinical team members and expanding the roles of team members with no prior clinical training.
Transformative Change: LEAP Webinar Series #4
What makes change transformative? The "Transformative Change" webinar was recorded in March 2014, and features speakers from LEAP sites at Dartmouth Hitchcock, Harvard Vanguard, and The Wright Center.
Building the Optimal Primary Care Team: LEAP Webinar Series #3
In Building the Optimal Primary Care Team, three LEAP teams present their team models and discuss the care and nurturing of an optimal care team. We ask these questions: how are optimal teams configured, what models are developing, and what techniques and processes help form, sustain and develop teams?
Models of Complex Care Management: LEAP Webinar Series #2
Multiple chronic illnesses, combined with co-existing mental/behavioral health problems, along with frailty and functional limitations pose great challenges to the work of the busy primary care team. The “Models of Complex Care Management” webinar was recorded in January 2014 and features the work of LEAP sites in Maine, Louisiana, Texas and West Virginia. This conversation asks how to build a system that supports the care of this population? How do we identify these patients?
Changing the Culture of Care in Your Community: LEAP Webinar Series #1
First in a series of six webinars recorded for our PCT-LEAP initiative, “Changing the Culture of Care in Your Community” showcases LEAP sites that are change agents in their communities even beyond their patient population, as well as doing the work of addressing the social determinants of health in a number of venues. We discuss the health care provider and team role in population health, and ask the question: how do you build and sustain community partnerships that transform both health care prac
LEAP Getting Started video
Short video describing the PCT-LEAP project, featuring RWJF Senior Program Officer Maryjoan Ladden, PhD, RN, FAAN and LEAP Co-Director Margaret Flinter, PhD, APRN. In MaryJoan Ladden's words, the LEAP Guide is "the nitty-gritty of how do you do it (deliver better primary care), getting it out there in a way that people can really practically use it."