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	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 3 No. 2, February 1994   Archives  • Online Features Prevention and Health Promotion  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Similar articles in this journal Changing Office Routines to Enhance Preventive Care The Preventive GAPS Approach Allen J. Dietrich, MD; Charlotte B. Woodruff; Patricia A. Carney, RN, MS Arch Fam Med. 1994;3(2):176-183. Abstract While family physicians aspire to provide their patients with the best possible preventive care, the services actually provided sometimes fall short of this ideal. Enhancing the provision of preventive care may require changes in office operations. Through working with more than 200 community practices in the Cancer Prevention in Community Practice Project, we have developed the Preventive GAPS Approach, which can help physicians and their practice staff to enhance their preventive care. The approach is based on teamwork among clinicians, staff, and patients; routines that encourage opportunistic provision of indicated preventive care; and flexibility, which allows physicians and their staffs to tailor their improvement strategy and the pace of change to their own unique situation. The approach includes the following four-step method (or GAPS): goal setting regarding preventive care; assessment of existing routines that support preventive care and of the current level of attainment of preventive goals; planning to modify existing routines that support preventive care; and starting and maintaining the improved preventive care office system. Author Affiliations From the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (Dr Dietrich and Ms Woodruff), and the Department of Community Health Care Systems, School of Nursing, University of Washington, Seattle (Ms Carney). THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Improving Female Preventive Health Care Delivery Through Practice Change: An Every Woman Matters Study Backer et al. J Am Board Fam Med 2005;18:401-408. ABSTRACT | FULL TEXT   Lost In Translation: The Value of Qualitative Data Lanier J Am Board Fam Med 2005;18:409-410. FULL TEXT   Improving Colorectal Cancer Screening by Targeting Office Systems in Primary Care Practices: Disseminating Research Results Into Clinical Practice Wei et al. Arch Intern Med 2005;165:661-666. ABSTRACT | FULL TEXT   A Pediatric, Practice-Based, Randomized Trial of Drinking and Smoking Prevention and Bicycle Helmet, Gun, and Seatbelt Safety Promotion Stevens et al. Pediatrics 2002;109:490-497. ABSTRACT | FULL TEXT   Evidence to action: a tailored multifaceted approach to changing family physician practice patterns and improving preventive care Lemelin et al. CMAJ 2001;164:757-763. ABSTRACT | FULL TEXT   Improving Adolescent Preventive Care in Community Health Centers Klein et al. Pediatrics 2001;107:318-327. ABSTRACT | FULL TEXT   Sun Protection Counseling for Children: Primary Care Practice Patterns and Effect of an Intervention on Clinicians Dietrich et al. Arch Fam Med 2000;9:155-159. ABSTRACT | FULL TEXT   A Community-based Randomized Trial Encouraging Sun Protection for Children Dietrich et al. Pediatrics 1998;102:e64-e64. ABSTRACT | FULL TEXT   Cancer Early-Detection Services in Community Health Centers for the Underserved: A Randomized Controlled Trial Dietrich et al. Arch Fam Med 1998;7:320-327. ABSTRACT | FULL TEXT   Volunteer Facilitators Assist Community Practices With Enhancing Cancer Control Woodruff et al. Arch Fam Med 1996;5:560-565. ABSTRACT   An Office System for Organizing Preventive Services: A Report by the American Cancer Society Advisory Group on Preventive Health Care Reminder Systems Leininger et al. Arch Fam Med 1996;5:108-115. ABSTRACT   Differences in the Frequency of Cholesterol Screening in Patients With Medicaid Compared With Private Insurance Hueston et al. Arch Fam Med 1995;4:331-334. ABSTRACT   GAPS in Family Planning Care Ferguson Arch Fam Med 1994;3:655-656. ABSTRACT   Computer-Assisted Preventive Care: Time to 'Byte' the Bullet? McPhee Arch Fam Med 1994;3:576-578. ABSTRACT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1994 American Medical Association. All Rights Reserved.