ask me! Confused by a project or priority that the PIT is working on? Ask your team to explain the project, and how it fits with the team’s goals. Need to brainstorm? Get ideas? We will connect you to our community of patient partners. Looking for information about the work that your PIT is doing? CHA has a wealth of staff-only online resources that you can use. Just let us know how we can help! Your PIT leader and I will do what we can to make this work satisfying and positive. -Ziva Ziva Mann Patient Partner, Patient Lead for Patient Centered Medical Home Getting Started checklist Welcome to the Practice Improvement Team! This is a checklist for you to use to complete the paperwork and steps for becoming a PIT member. All forms need to be completed before your first team meeting. Allow 45 minutes before your first team meeting to fill out the onboarding forms and review basic concepts with the PIT leader. Patient Partner agreement: this describes your role as a member of a Practice Improvement Team. It also describes what the team’s responsibilities to support you. W9: this form allows Cambridge Health Alliance to pay you a monthly stipend. CORI: this form allows Cambridge Health Alliance to make sure that you don’t have a criminal record. If there is something in your past experience that may turn up on a CORI form, please consider discussing this with the PIT leader. Your experiences are part of what makes you valuable to the Practice Improvement Team, and that part may also be of value. Photocopy of photo ID Patient Partner Privacy/Security Agreement: this is your agreement that you will keep private any patient health information that you may learn while on a PIT team. Confidentiality and User Access Agreement: this is your agreement to protect access to Cambridge Health Alliance’s staff-only internet and online resources. Influenza Declination Form: as a patient partner, you are eligible for a free flu shot. If you choose not to get a flu shot from CHA, you should sign this form. Email or call Ziva Mann, Patient Lead (, 617 905-5905). *******************
ask me! Confused by a project or priority that the PIT is working on? Ask your team to explain the project, and how it fits with the team’s goals. Need to brainstorm? Get ideas? We will connect you to our community of patient partners. Looking for information about the work that your PIT is doing? CHA has a wealth of staff-only online resources that you can use. Just let us know how we can help! Your PIT leader and I will do what we can to make this work satisfying and positive. -Ziva Ziva Mann Patient Partner, Patient Lead for Patient Centered Medical Home Getting Started checklist Welcome to the Practice Improvement Team! This is a checklist for you to use to complete the paperwork and steps for becoming a PIT member. All forms need to be completed before your first team meeting. Allow 45 minutes before your first team meeting to fill out the onboarding forms and review basic concepts with the PIT leader. Patient Partner agreement: this describes your role as a member of a Practice Improvement Team. It also describes what the team’s responsibilities to support you. W9: this form allows Cambridge Health Alliance to pay you a monthly stipend. CORI: this form allows Cambridge Health Alliance to make sure that you don’t have a criminal record. If there is something in your past experience that may turn up on a CORI form, please consider discussing this with the PIT leader. Your experiences are part of what makes you valuable to the Practice Improvement Team, and that part may also be of value. Photocopy of photo ID Patient Partner Privacy/Security Agreement: this is your agreement that you will keep private any patient health information that you may learn while on a PIT team. Confidentiality and User Access Agreement: this is your agreement to protect access to Cambridge Health Alliance’s staff-only internet and online resources. Influenza Declination Form: as a patient partner, you are eligible for a free flu shot. If you choose not to get a flu shot from CHA, you should sign this form. Email or call Ziva Mann, Patient Lead (, 617 905-5905). *******************
Cambridge_Health_Alliance_practice_improvement_team_toolkit.docx