Resource Library

Behavioral Health

Resources that pertain to mental health, mental illness, and substance abuse. Resources include providers and mobile crisis information. Tools include safety assessments.

Examples: PHQ9, county mobile crisis contact information, mental health, mental illness, addictions, New York state

Resources

Tools

Chronic Conditions

Resources and information that pertain to chronic medical conditions. Sub folders will include case studies, literature, PDSAs, resources, and tools. Tools subfolders are separated by specific conditions. Resources for chronic conditions will include patient teaching tools, support services, and health literacy appropriate literature. For information on depression, see behavioral health.

Examples: chronic disease red flag teaching tools, insulin administration education, selfmanagement literature for patients, clinician focused literature

Literature

Resources

Tools

End of Life

Information and resources that pertain to end of life planning and care. Sub folders will include case studies, literature, PDSAs, resources, and tools.

Examples: Hospice homes, MOLST forms

Case Studies

Resources

General Folder

Resources that benefit various patient populations and do not fit into any other categories listed. Sub folders will include literature, resources, and tools. Resources for the general folder will include health ministries, support services for children, developmental disability services (non-waiver programs), and resources for blind/deaf populations.

Example: Interdenominational Health Ministry Coalition, Rochester-area Healthcare Service Agencies and Support Groups

Resources

Insurance and Government Assistance Programs

Resources that pertain to insurance programs, including private insurance, Medicare, and Medicaid, as well as managed care and managed long term care plans.  Resources will be included for programs that offer government funded assistance to income eligible persons.  Subfolders will include Case Studies, Literature, Waiver Services, Resources, and Tools.

Examples: multiple pharmacy programs, EPIC, neighborworks information. 

Resources

Patient Activation

Definition: Resources that pertain to assessing or building knowledge, skills and confidence among patients with the goal of managing their own health and health care. Resources for patient activation include low literacy tools to manage chronic conditions; training materials for motivational interviewing and teach back; and studies of effective self-management.

Examples: management tools for asthma, COPD, diabetes, heart failure, pneumonia, and patients who take Warfarin.

Literature

Motivational Interviewing

  • Motivational Interviewing module - Module from Practice Advisor that introduces the concept of Motivational Interviewing (MI), including the theoretical basis of MI; clinical tools of MI; and practical guidance on integrating MI into a medical practice.

Resources

  • Statewide
    • A1C Thermometer - Instructions for patients to better understand A1c and healthy numbers.  Appropriate for most literacy levels.
    • Symptoms of high and low blood sugar - Instructions to help patients identify when to check their blood sugar.  Appropriate for most literacy levels.
    • Eating well with diabetes - Instructions to educate patients on eating when diabetic.  Appropriate for most literacy levels.
    • Insulin administration - Diagram instructions to educate patients on giving themselves insulin.  Appropriate for most literacy levels.
    • Medicine log - Tool to educate patients about specific medications and allows them to log medications they've taken.  Appropriate for most literacy levels.
    • Medical home vs. emergency department - Instructions for patients on when to go to the doctor vs. when to go to the emergency room.  Created by a community health center in Rushville, NY.
    • Medicines for diabetes - Information on diabetic medications and how they control diabetes.  Appropriate for most literacy levels.
    • Patient Safety Network - Information on medication reconciliation.
  • Regional

Teach Back

Tools

Reimbursement

Definition: Resources that pertain to payment models, billing codes, and government policy related to reimbursement.  Sub folders will include literature, resources, and tools.  Resources for reimbursement include presentations, examples of forms, and summary documents.

Examples: presentation on the Medicare Access and Chip Reauthorization Act of 2015; examples of forms used for Chronic Care Management billing codes. 

Resources

Senior Services

Definition: Resources that pertain to adults 60 years of age and older.  Sub folders will include case studies, literature, PDSAs, resources, and tools.  Resources will not include information that pertains to other folders, but rather to help seniors with aging in place, move to higher living, and obtain services that pertain specifically to aging.

Examples: silver sneakers resources, literature on treating persistent pain in older adults, geriatric care management information 

Literature

Resources

  • Statewide
  • Regional
    • Eldersource - Monroe County resources for older adults and disabled adults.
    • Grandma’s Helpers Brochure - Agency that helps older adults with transitioning from aging in place to moving to a higher level of care.  Assistance includes helping with moving estimates, movers, packing, and cleaning.
    • Silver Sneakers Programs 

Social Determinants of Health

Resources that pertain to psychosocial factors that impact an individual’s ability to access healthcare or maintain satisfactory health. Sub folders will include Case Studies, Literature, and
Resources. Resources for social determinants of health include cash assistance, benefits information, and food and housing issues.

Examples: HEAP/Project Share Heating Fund information, SNAP, and food cupboards.

Resources

Transitions in Care

Definitions: This will provide resources and information that pertain to transitions in care. Sub folders will include case studies, literature, resources, and tools. Resources for transitions in care include transitions tools and processes for practices from AMA, ACP, and AHRQ.

Examples: AMA Transitions in Care – Putting the Pieces Together, AHRQ Transitions Implementation Handbook, and the National Transitions in Care Collaborative Issue Briefs.

Literature

Resources

Tools

Transportation

Resources that pertain to transportation for patients.  Transportation will include transporting for medical appointments, social activities, and personal needs.  Transportation for Medicaid recipients as well as private pay will be included.

Examples: Transportation vendors and rates

Resources