Institute for Healthcare Improvement: Follow Up and Monitor Self-Management Goals

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Self-Management:

Follow Up and Monitor Self-Management Goals

Train staff for follow-up.
Test having different staff or volunteers do follow-up.
Schedule follow-up based on dates in the action plan.
Test follow-up mechanisms (calendar, registry, tickler file) and scripts.
Include problem solving (a technique to help patients identify problems and develop solutions) in follow-up.

Tips

Don't skip follow-up; patients will think you don't care.
Make sure patients determine the follow-up date and method. Follow-up can be by phone, email, fax, home visit, clinic visit, etc.
Use trained, culturally competent lay people for follow-up.



Self-Management Measures How to Improve

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