Purba,
Your program fits nicely with this framework.
For the Tool Platform, you actually state that it will be a “pocket” and “poster” in your answer to #1. The pre-clinic conferences may be part of your implementation plan, but the platform would be pocket/poster. Think hard about the advantages/weaknesses of this approach. As an enabling strategy, some of the most critical issues are to make the algorithm/decision support available at the point of decision making, and reduce barriers and inertia to using it. The poster is good—right there. But the pocket may get lost or not accessed. Physicians sometimes also feel funny “looking things up” in front of the patient during a visit. Embedding it in the EMR is one way to hide it.
Your PER worksheet is excellent. Hard to add anything else to this. You might also think creatively of ways in which patients can provide positive reinforcement if you get them on-board too. Also think about ways to provide peer-profiling and finding “positive deviants” who do it well to teach/share their secrets with the rest of the group.