2017 - Competency KM-F

Table of Contents

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Competency F: The practice identifies/ considers and establishes connections to community resources to collaborate and direct patients to needed support

KM 21 (Core): Uses information on the population served by the practice to prioritize needed community resources

The practice identifies needed resources by assessing collected population information. Practice may assess social determinants, predominant conditions, emergency department usage and other health concerns to prioritize community resources (e.g. food banks, support groups) that support the patient population.

As evidence, the practice must provide a list of key patient needs and concerns

KM 22 (1 Credit): Provides access to educational resources, such as materials, peer-support sessions, group classes, online self-management tools or programs

Giving patients access to educational materials, peer support sessions, group classes and other resources can engage them in their care and teach them better ways to manage it, and help them stay healthy. The practice provides three examples of how it implements these tools for its patients.

• Educational programs and resources may include information about a medical condition or about the patient’s role in managing the condition. Resources include brochures, handout materials, videos, website links and pamphlets, as well as community resources (e.g., programs, support groups).

• Self-management tools enable patients to collect health information at home that can be discussed with the clinician. Patients can track their progress and adjust the treatment or their behavior, if necessary. Such as a practice gives its hypertensive patients a method of documenting daily blood pressure readings.

KM 23 (1 Credit): Provides oral health education resources to patients

The practice provides an example of how it provides patients with educational and other resources that pertain to oral health and hygiene.

KM 24 (1 Credit): Adopts shared decision-making aids for preference-sensitive conditions

The care team has, and demonstrates use of, at least three shared decision-making aids that provide detailed information without advising patients to choose one option over another. The care team collaborates with patients to help them make informed decisions that align with their preferences and values. Engaging patients in understanding their health condition and in shared decision making helps build a trusting relationship.

More information and resources can be found through the International Patient Decision Aid Standards Collaboration (IPDASC).

KM 25 (1 Credit): Engages with schools or intervention agencies in the community

The practice develops supportive partnerships with social services organizations or schools in the community. The practice demonstrates this through formal or informal agreements or identifies practice activities in which community entities are engaged to support better health. Documented process and evidence of implementation is required.