Clinical Systems Improvement

Resources for Health Care Providers/Institutions

• Clinical Tools:
  Flow Sheets | Self Management Goal Setting Tools | Action Plans | Chart Stickers | Referral Forms | Reminder Tools | Questionnaires
• Patient Education Tools:
  Fact Sheet | Health Bulletin | Easel, Brochures and Palm Cards | Posters | Personal Health Records | NYC Vital Signs
• Provider Resources:
  City Health Information (CHI) | Pocket & Other Guides | Services Guides | Guidelines

Clinical Tools

Flow Sheets

• Adult Preventive Care Flow Sheet
• Contraception:
  • Sexual History Form
• Diabetes:
  • Diabetes Care Flow Sheet
• HIV Testing:
  • HIPPA Compliant Authorization for Release of Medical Information and Confidential HIV-Related Information Form
• Hypertension:
  • Hypertension/Dyslipidemia Flow Sheet
• Influenza & Other Immunizations:
  • Vaccine Administration Record

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Self-management Goal Setting Tools

• Depression:
  • Depression Management Goal Sheet
    Other languages: [En Español][中文][Русский][한국어][Bengali][Creole]
• Hypertension:
  • Blood Pressure Management Goal Sheet
    Other languages: [En Español]

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Action Plans

• Asthma:
  • Taking Action with an Asthma Action Plan
    Other languages: [En Español]
• Diabetes:
  • If you have diabetes, know and control your ABCS: A1C, Blood pressure, and LDL “bad” cholesterol Action Plan
    Other languages: [En Español][中文][Русский]
• HIV Testing:
  • Protocol for HIV Results: A Health Care Provider Plan of Action
• Hypertension:
  • High Blood Pressure Action Plan
    Other languages: [En Español]

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Chart Stickers

• Asthma:
  • NAEPP Classification of Asthma Severity Chart Sticker
• Colon Cancer:
  • “Is Colon Cancer Screening Needed?" Chart Sticker
• Contraception:
  • Prevent Unintended Pregnancy Chart Sticker
• Depression:
  • PHQ-2 Chart Sticker
• Diabetes:
  • Diabetes ABCS Chart Sticker
  • Diabetes Foot Exam Chart Sticker
• HIV Testing:
  • HIV Testing Chart Sticker
• Hypertension:
  • Hypertension Treatment “Is it time for a change?” Chart Sticker
• Influenza:
  • Double Check for Prevention Chart Sticker – Adult
  • Double Check for Prevention Chart Sticker – Pediatric
• Tobacco:
  • Vital Signs Chart Sticker

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Referral Forms

• Colon Cancer:
  • General Referral for Colonoscopy
• Contraception:
  • Contraception Services Referral Form
• Depression:
  • Referral to Mental Health Services
• HIV Testing:
  • Referral to HIV Primary Care Services

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Reminder Tools

• Colon Cancer:
  • Colon Cancer Screening Birthday Reminder Card
• Emergency Contraception:
  • Ask Me About Emergency Contraception Stickers
• Influenza:
  • Get Your Flu Shot Postcard

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Questionnaires

• Depression:
  • Patient Health Questionnaire (PHQ-9)
    
• Influenza & Other Immunizations:
  • Do I Need Any Vaccination Today? Tear-off Pads
    Other languages: [En Español]
• Tobacco:
  • Smoking Questionnaire

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Patient Education Tools

Fact Sheets

• Asthma:
  • Your Asthma Medicines
    Other languages: [En Español]
  • Anti-Histamines
    Other languages: [En Español]
  • Bronchodilators
    Other languages: [En Español]
  • Cromolyn Sodium (Intal)
    Other languages: [En Español]
  • Inhaled Corticosteroids
    Other languages: [En Español]
  • Leukotriene Modifiers
    Other languages: [En Español]
  • Oral Corticosteroids
    Other languages: [En Español]
• Contraception:
  • Birth Control – What's Right for You?
    Other languages: [En Español]
  • I Can't Get Pregnant – True or False?
    Other languages: [En Español]
  • NYCLU Minor's Rights to Confidential Reproductive HealthCare in New York
• Depression:
  • Common Symptoms of Depression
    Other languages: [En Español]
  • Tips for Handling Depression
    Other languages: [En Español]
• Diabetes:
  • Healthy activity can help BEAT diabetes
    Other languages: [En Español][中文][Русский]
  • Healthy eating can help BEAT diabetes
    Other languages: [En Español][中文][Русский]
  • Diabetes and Smoking: A Risky Combination
    Other languages: [En Español]
• HIV Testing:
  • If Your HIV Test is Positive Information Sheet
    Other languages: [En Español]
  • New York State Department of Health Post-Negative Information Sheet
• Hypertension:
  • Eat and Drink to Lower Blood Pressure Fact Sheet
    Other languages: [En Español]
  • Learn to Read Food Labels Fact Sheet
    Other languages: [En Español]
  • DASH to the Diet – healthy eating plan

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Health Bulletins

• Take Care New York:
  • #15 – Take Care New York
• Asthma:
  • #18 – Asthma – What's Your Plan?
    Other languages: [En Español][中文]
• Colon Cancer:
  • #4 – Get Checked for Colon Cancer
    Other languages: [En Español]
• Depression:
  • #34 – Get Help for Depression
    Other languages: [中文][Русский]
• Diabetes:
  • #38 - Diabetes is epidemic
    Other languages: [En Español][中文]
• Healthy Heart:
  • #30 – Healthy Heart – Blood Pressure
    Other languages: [Español][中文][Русский][Urdu]
  • #42 – Healthy Heart – Cholesterol
  • #36: Healthy Heart - Cut the Salt!
    Other languages: [Español][中文][Русский][Bengali][Urdu]
  • #26 – Eat Less Trans Fat
    Other languages: [Español][中文][Русский][Urdu][Bengali][Creole]
• Healthy Weight:
  • #9 - Healthy Weight
    Other languages: [Español]
• Tobacco:
  • #2 - Be Tobacco-Free
    Other languages: [En Español][中文][Русский]
• Women's Health:
  • #40 – Women's Health
    Other languages: [Español][中文]
• Click here for other Health Bulletins

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Easel, Brochures and Palm Cards

• Asthma:
  • Kick Asthma Easel with Patient Survey
  • Kick Asthma Palm Card
    Other languages: [En Español]
• Colon Cancer:
  • Get Checked. 50 or Older? Get a Colonoscopy to Prevent Colon Cancer (brochure)
    Other languages: [En Español]
• Contraception:
  • Emergency Contraception Easel
  • Emergency Contraception Palm Card
    Other languages: [En Español]
• Depression:
  • Depression. It's treatable. Talk to Your Doctor Easel
  • Depression. It's treatable. Talk to Your Doctor Palm Card
    Other languages: [En Español]
• Diabetes:
  • BEAT diabetes (palm card)
    Other languages: [En Español][中文][Русский]
• HIV Testing:
  • Everyone Should Get Tested for HIV Easel (English/Espanol)
  • Everyone Should Get Tested for HIV Palm Card
    Other languages: [En Español]
• Hypertension:
  • Act now! Control Your High Blood Pressure Easel
  • Act now! Control Your High Blood Pressure Palm Card
    Other languages: [En Español]
• Immunization:
  • Don't Let the Flu Spoil your Fun Brochure
    Other languages: [En Español]
  • Don't Let the Flu Spoil your Fun Easel
• Tobacco:
  • Everybody Loves a Quitter Easel with Smoking Questionnaire
  • Everybody Loves a Quitter Palm Card
    Other languages: [En Español]

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Posters

• Asthma:
  • Kick Asthma
    Other languages: [En Español]
• Colon Cancer:
  • Get Checked
    Other languages: [En Español]
• Contraception:
  • I Almost Got Pregnant
    Other languages: [En Español]
  • Which Woman are You?
    Other languages: [En Español]
• Depression:
  • Depression. It's Treatable. Talk to Your Doctor
    Other languages: [En Español]
• Diabetes:
  • BEAT diabetes
    Other languages: [En Español][中文][Русский]
• Emergency Contraception:
  • Emergency Contraception Poster – Note: For pharmacy use
    Other languages: [En Español]
• HIV Testing:
  • Everyone Should Get Tested for HIV Poster
    Other languages: [En Español]
• Hypertension:
  • Act now! Control your high blood pressure Poster
    Other languages: [En Español]
• Immunization:
  • Don't Let the Flu Spoil your Fun
    Other languages: [En Español]
• Tobacco:
  • Everybody Loves a Quitter
    Other languages: [En Español]

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Personal Health Records

• Take Care New York:
  • Passport to Your Health
    Other languages: [En Español]
• Diabetes:
  • My Diabetes CheckBook: A tool to help keep your diabetes under control
    Other languages: [En Español][中文][Русский]
• Hypertension:
  • Blood Pressure Tracking Card
    Other languages: [En Español]

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NYC Vital Signs

• Asthma
  • Asthma Can Be Controlled – Vol. 2, #4 April 2003
• Colon Cancer
  • Cancer Screening in New York City – Vol. 2, #2 March 2003
• Diabetes
  • Diabetes is Epidemic – Vol. 2, #1 January 2003
• Immunization
  • Immunization to Prevent Influenza and Pneumonia – Vol. 1, #1 December 2002
• Click here for other Vital Signs

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Provider Resources

City Health Information (CHI)

• Depression:
  • Detecting and Treating Depression in Adults – November 2007 – Vol. 26(9):59-66
• Diabetes:
  • Diabetes Prevention and Management – January 2005 – Vol. 24(1):1-6
• Colon Cancer:
  • Preventing Colon Cancer – March 2003 – Vol. 22 No. 2
• Contraception:
  • Contraception – Encouraging Its use – March 2005 – Vol. 24(3):13-20
• HIV Testing:
  • Making HIV Testing a Routine Part of Medical Care – February 2006 – Vol. 25(2):9-12
• Hypertension:
  • Management of Hypertension in Adults – October 2005 – Vol. 24(7):39-50
• Influenza:
  • Influenza: Prevention and Control, 2005-2006 – October 2005 – Vol. 24(6):35-38 References
• Tobacco:
  • Treating Nicotine Addiction – April 2005 – Vol.24(4):21-28
• Click here for other City Health Informations (CHIs)

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Pocket & Other Guides

• Key Preventive Services for Adults Pocket Guide
• Asthma:
  • Survey Interpretation Card
• Contraception:
  • Contraception Pocket Guide
  • NYCLU Minor's Rights to Confidential Reproductive HealthCare in New York
• Depression:
  • Depression Screening Pocket Guide
• Diabetes:
  • BMI calculator wheel (Not available online)
• Emergency Contraception:
  • Emergency Contraception Fact Sheet for Pharmacists
  • Emergency Contraception: A Practitioner's Guide from Physicians for Reproductive Choice and Health
• Hypertension:
  • Hypertension Pocket Guide
  • Patient Self-Monitoring of Blood Pressure: A Provider's Guide
• Influenza:
  • Influenza Vaccination Pocket Information Guide
• Tobacco:
  • Treating Nicotine Addiction Pocket Guide

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Services Guides

• Colon Cancer:
  • Low-Cost Colonoscopy Programs
• Contraception:
  • Guide to Reproductive Health Services in New York City
• Depression:
  • Lifenet
• HIV Testing:
  • Contact Notification Assistance Program (CNAP) Card
  • Guide to Designated AIDS Centers in New York City
  • Guide to NYC DOHMH STD Clinics
  • Reporting at a Glance: Five Things to Know About HIV/AIDS Reporting
  • Protocol for HIV Results: A Health Care Provider Plan of Action
• Influenza:
  • Influenza Vaccine Supply and Recommendations for Prioritizing Risk Groups – New York City, 2005-2006 Season
  • Medicare Administration Rate Allowances for Influenza and Pneumococcal Vaccines – New York City, 2004-2005

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Guidelines

• Asthma:
  • Clinical Guideline for the Diagnosis, Evaluation, and Management of Adults and Children with Asthma – 2005 (Developed by the New York State Consensus Asthma Guideline Expert Panel)
• Influenza & Other Immunizations:
  • Recommended Adult Immunization Schedule 2002-2003

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