This publication, A Step-by-Step Guide to Delivering Clinical Preventive Services: A Systems Approach, was adapted from the Texas Department of Health (TDH) Adult Health Program Manual (Texas Manual) and the TDH Implementation Guide for Clinical Preventive Services (Texas Guide).
The Texas Manual was written by staff members of the Adult Health Program at TDH: Crystal Wilkinson, MSN, RN; Rick Danko, PhD; and Sylvia Harris, RN. The Texas Guide was written by Barbara S. Meyer, MS; Michele Murphy-Smith, PhD, RN, RD; Alexandra E. Evans, PhD; and Nell H. Gottlieb, PhD, all of The University of Texas at Austin, and by Patricia Goodson, PhD, of Texas A&M University. The authors received support from and collaborated with the TDH Adult Health Program team, including Philip Huang, MD, MPH; Pamela Mathison, MA, RN; and Patsy Harper, RNC, and from Put Prevention Into Practice regional consultants.
In addition to the people and sites mentioned above, the Agency for Healthcare Research and Quality (AHRQ) extends special appreciation to Ms. Harper and Dr. Smith, members of the TDH-University of Texas action research team, who kindly lent much of their time, expertise, and encouragement. AHRQ also thanks Barbara Clark, Eve N. Shapiro of Equals Three Communications, and Joel Boches of AHRQ for writing, editing, and designing this Guide.
Put Prevention Into Practice: The Texas Experience
Since 1994, the Texas Department of Health (TDH) has promoted the implementation of the Agency for Healthcare Research and Quality's Put Prevention Into Practice (PPIP) program in various clinical settings throughout Texas. To encourage the implementation of a system for preventive services delivery, the TDH provided start-up funds to primary care sites—local health departments, community health centers, family practice residency programs, and other nonprofit primary care clinics.
Sites were expected to use the money to build an infrastructure through which effective preventive care would be delivered. The TDH developed the Implementation Guide for Clinical Preventive Services in response to PPIP demonstration sites' requests for assistance. The developers of that guide used observation and staff interviews at the demonstration sites to gather information for its content.
The TDH also trained public health nurses to serve as consultants and provide technical assistance to the sites. The consultants worked with the sites to assess staff readiness to implement a system for the delivery of clinical preventive services, ensure that the system tools are used effectively, monitor PPIP chart documentation, and help sites link to local resources for referrals. Funds also were awarded to The University of Texas at Austin to evaluate the delivery of clinical preventive services using PPIP materials and to identify barriers and facilitators to using the PPIP program.