Step Three: Finalize Coaching Workflows

Your Coaching and Administrative Workflow describes how clinical providers, coaches, and administrative team members work together to serve patients in Twine. Specific components of Clinical/Administrative Workflows include:

  • Internal/external referral management
  • Appointment Scheduling
  • Clinical Decision Making: What is the process for e-Prescribing, medication changes, communication through Twine, and communication through meeting structures?

Depending on whether your coaching team is remote, partially remote, or on-site, how you approach these workflows may be different.

A mention about measurement alerts:

Twine's platform notifies coaches when a measurement alert has been entered by their patients. We encourage Twine coaches to respond to these measurement alerts first in their workflows. This ensures that patients whose blood pressure and blood sugar levels fall into the high risk range (blood pressures over 140/90 mmHg and blood sugars over 130 mg/DL) are communicated with and cared for.

Your organization may consider an internal protocol to support your coaches in addressing these values. The goal of your measurement alert response protocol should be twofold: (1) ensure patient safety, and (2) support your coaches in turning measurement alerts into teachable moments for change. 

How you meet these goals is up to your organization. Here are some ideas to consider in developing measurement alert response plans:

  • When should a coach inform a primary care provider that they are observing measurement alerts? Some organizations define specific criteria (e.g. blood sugars >300 mg/DL) and outreach methods for their coaches. Consider a way to identify patients in need without overburdening the coaching process.
  • The @-mention feature in the message stream can allow coaches and primary care providers to communicate in a way that is timely and transparent. If you'd like this feature to be leveraged, ensure that primary care providers have access to Twine and know to read their messages regularly. 
  • What is your organization's expectation for follow-up by the coach after measurement alerts are observed? By the primary care provider?
  • What other expectations do you have for coaches with regard to measurement alerts? Communicate and make this information accessible!

Once you've decided on how you'd like coaches to respond to measurement alerts, communicate the plan and observe how well the team addresses measurement alert compared to the expected plan. Over time, you may iterate your plan based on how well it is working to support coaches and patients in quality coaching care.

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