Lesson 1Defining roles and task delegation among nurse, doctor, receptionist, and social workerThis section clarifies how to define and document roles for nurses, doctors, receptionists, and social workers, including task delegation, handoffs, scope limits, and backup plans that support safe, efficient primary care workflows.
Mapping core tasks across the care pathwayRole descriptions for each team memberSafe task delegation and supervision rulesStandard handoffs between team membersBackup coverage and cross-training plansLesson 2Appointment adherence and missed-visit interventions: reminder logs, phone/text prompts, and rebooking protocolsThis section covers systems to improve appointment adherence, including reminder logs, phone and text prompts, rebooking protocols, and follow-up of high-risk patients, aiming to reduce missed visits and maintain continuity of primary care.
Designing and maintaining appointment reminder logsStandard phone and SMS reminder scriptsTiming and frequency of reminder contactsRebooking workflows after a missed visitFlagging and following high-risk patientsLesson 3Problem-solving huddles and daily briefings for backlog and supply issuesThis section explains how to organize brief daily huddles to address backlogs, staffing gaps, and supply issues, including roles, agenda, documentation, and follow-up actions that keep the primary care clinic running smoothly and safely.
Setting a fixed time and duration for huddlesDefining roles for huddle facilitationRapid review of backlog and wait timesIdentifying urgent supply or staffing gapsDocumenting action items and ownersLesson 4Two simple quality indicators to track (example: % diabetics with HbA1c in last 6 months; % hypertensives with BP recorded in last 3 months)This section introduces two simple quality indicators, such as HbA1c testing for diabetics and blood pressure recording for hypertensives, and explains how to define numerators, denominators, targets, and reporting formats for the team.
Defining numerators and denominatorsSetting realistic indicator targetsExample: HbA1c testing coverageExample: blood pressure recording rateSimple run charts for team feedbackLesson 5Staff training plan: in-service topics, refresher checklists, and competency documentationThis section outlines how to build a staff training plan, including in-service topics, refresher schedules, checklists, and competency documentation, ensuring that all team members maintain skills needed for safe primary care delivery.
Identifying priority in-service topicsCreating annual training schedulesDesigning refresher checklists by roleMethods to assess staff competenciesMaintaining training and skills recordsLesson 6How to review indicators in meetings and translate to small PDSA-style testsThis section shows how to review simple indicators in team meetings and convert findings into small PDSA-style tests, including selecting measures, planning changes, tracking results, and deciding whether to adopt, adapt, or abandon a change.
Choosing practical indicators for the teamPreparing indicator summaries for meetingsBasic steps of a PDSA cycle in clinicsDocumenting small tests of changeReviewing results and next-step decisionsLesson 7Common problems: missed appointments and lost charts — prevention and remediation workflowsThis section addresses common problems such as missed appointments and lost charts, describing prevention strategies, standardized remediation workflows, documentation, and monitoring to reduce recurrence and protect patient safety.
Standard workflow for missed visitsPreventing missed appointments proactivelyTracking and locating missing chartsReconstructing essential clinical dataMonitoring trends and recurring issuesLesson 8Data collection methods for indicators using paper registries and samplingThis section explains practical data collection methods for indicators using paper registries and sampling, including tally sheets, sampling frames, data quality checks, and simple aggregation for use in team meetings.
Designing simple tally sheets and logsSampling from paper registriesAvoiding double counting and omissionsBasic data quality checks and correctionsSummarizing data for team reviewLesson 9Designing a weekly team meeting agenda: attendance, duration, and standing itemsThis section guides teams in designing a weekly meeting agenda, including attendance, duration, standing items, rotating topics, and simple documentation, so meetings stay focused, efficient, and linked to follow-up actions.
Selecting required and optional attendeesSetting meeting length and ground rulesDefining standing agenda itemsRotating topics for training and reviewRecording minutes and tracking actionsLesson 10Managing supply shortages: stock cards, minimum stock levels, and substitution guidanceThis section addresses managing supply shortages using stock cards, minimum stock levels, ordering schedules, and substitution guidance, helping teams prevent stockouts and respond safely when essential items are limited.
Setting and updating minimum stock levelsUsing and auditing stock cards regularlyRoutine ordering and delivery schedulesEarly warning signs of stock shortagesSafe substitution and rationing guidance
