The Assessment of Primary Care Resources and Supports for Chronic Disease Self Management (the “PCRS”) was developed by the Diabetes Initiative of the Robert Wood Johnson Foundation ( The purpose of the PCRS, broadly, is to facilitate quality improvement of self management support in primary care. Specifically, the PCRS:
  1. Defines characteristics and levels of capacity for patient and organizational supports of self management
  2. Provides a way for patient care teams to assess current capacity in both areas--patient support and organizational support
  3. Helps identify specific gaps in capacity and/or lack of agreement about capacity so that team members know where to focus their improvement efforts
  4. Promotes discussion among patient care team members that can help build consensus for change and plans for improvement
  5. Gives teams a way to measure progress over time.

Who should use this tool?
This tool is for providers in primary health care settings who are interested in improving self management support and integrating it into chronic illness care. The PCRS is intended to be used with multi-disciplinary teams representing front line staff, clinicians and administrative personnel.

How is it used?
This tool is intended for use by teams interested in improving the quality of their self management support systems and service delivery. Each member of the team fills out the assessment independently, reflecting a specified period of care delivery (e.g., last quarter). When all members have completed the tool, it is recommended that they meet to discuss the items and their ratings. Paying particular attention to discrepancies among team member scores provides an important opportunity to discover gaps in knowledge, capacity or services. The value of this tool, then, is not in the scores per se, but in the improvement processes initiated from team discussions. Using the PCRS for periodic re-assessment gives teams a way to measure the impact of their improvement processes and facilitates integration of self management supports into their systems of care.

For more information on PCRS: