“Providing self-management support presents a major challenge to primary care practices because self-management support takes time – perhaps the most limited resource in primary care. Physicians cannot provide adequate self-management support amid the many competing agendas of a 15-minute office visit. Thus, primary care practices must create teams in which non-physician caregivers are trained to work with physicians in offering self-management support, from information giving and collaborative decision making to assessing patients’ readiness to change health-related behaviors and setting behavior change goals.” From “Helping Patients Manage Their Chronic Conditions.” 6/05 California Health Care Foundation (Bodenheimer, MacGregor and Sharifi)
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The Process of Redesign
In Getting Started with Redesign, we look at the initial steps in the design process:
- Diagramming the work flow of your practice
- Discussion of tasks, functions and roles - usually leading to some reassignments
- Preparation and training needed for staff to perform their new tasks effectively.
In Design Options, you will find information about the sorts of changes practices have made in order to enhance support for patient self-management and promote closer provider/patient collaboration while improving the efficiency and effectiveness of care.
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Tips and Tools
Fundamental Questions
Fundamental questions practices ask when trying to improve support for patient self-management are:
- What do we do now? (Are we using our existing staff and other resources as effectively as we could be?)
- What could we to do differently? (What are some optimal ways to do these things?)
Careful Planning and Staff Preparation
Changing the delivery of care requires both careful planning and a good deal of staff preparation.
Modest Objectives
It’s good to set modest objectives, initially. This makes adjustments easier and increases the odds that early efforts will be successful and team motivation to continue will be high.
Start With What You Care Most About
It is best to start with those things that you care most about – usually that means what is most likely to be helpful to and appreciated by patients.
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Resources