Establish Workflow: Patient Self-management

Steps to Define Patient Self-management Workflow

Map the current workflow for an office visit

Your care team should diagram exactly how an office visit currently works before considering how to change it to include patient self-management support (PSMS). This primer on process mapping(2 page PDF) shows how to create a map of the current process.

Modify the workflow to incorporate PSMS

Keeping the care team's experience with PSMS skills and tools in mind, decide how PSMS can best be integrated into the office visit. Questions about roles and responsibilities could include:

  • When should motivational interviewing be used, and by whom?
  • Who should work with the patient to develop realistic, incremental goal(s)?
  • Who should work with the patient to prepare the written action plan for achieving the goal?
  • Who should set the follow-up appointment?
  • Who should call the patient between visits to check progress and answer questions?
  • If needed, who should train the patient in self-monitoring techniques, such as use of a blood glucose monitor or a peak flow meter?
  • Who should develop and maintain a list of outside resources to provide to patients to help them achieve goals?

Determine how to shift workloads to accommodate new roles and responsibilities, then create a new process map that incorporates PSMS and new roles/responsibilities.

Document your decisions

Keep a record of your decisions and the new workflow. You also may need to update job descriptions.

Try it out

The new workflow may look good on paper, but put it into practice to make sure. A test run with a small group of patients will tell you whether the workflow needs modification to operate smoothly.

What you will need

  • Decision-making authority
  • Time to meet
  • A way to document decisions and new processes (e.g., office manual)
  • Time to test the new workflow

Difficulty: Easy, unless there is resistance to change

Outcome: A workflow that accommodates patient self-management support

Time to Complete: Two weeks