Mapping your processes and pathways
Now that you have established your improvement team and ways of working, the next step will be to understand your current system. Understanding your system is an essential step a thorough diagnostic will highlight constraints, bottlenecks and waste across your pathway.
Information gathered, will also support engagement with key stakeholders to build the will and further highlight the need for change.
Process mapping – a visual display that shows where, a process starts and ends and the sequence of steps in-between in the order that they happen. Process maps can be, used at different levels from a high level, less detailed map to a more detailed process map that breaks down bigger steps into smaller chunks depending on the level of analysis required.
Last 10 patients – uses patient information to, identify variation in journey times, helping you, understand what is happening in the patient pathway and how this can vary from patient to patient.
Service user and provider experience
Before you design a mechanism for capturing service user/provider experience and insights, consider the use of models already in place:
- Care Opinion
- Significant clinical incident reviews
Care Opinion – are there any comments and insights that can be, gained for reviewing care opinion? There may be some areas for improvement identified, that can support the improvement of your service.
Community engagement – Healthcare Improvement Scotland Community Engagement tools:
Care Experience Model – a simple framework that supports health and social care teams to make improvements that are directly, related to feedback in a person-centred way.
Empathy map – tool providing a series of prompts to identify a target group’s thoughts, feelings, motivations, desires, and needs.
User journey map – Tool to capture user experience of a service at different stages of their journey
Measuring System Flow
When seeking to improve flow it is important to, continuously analyse data on demand, capacity, activity and queues.
- Demand – all the work that is entering the system
- Capacity – how much work could be done considering all of the resources needed
- Activity – actual work done, it is the throughput of the system
- Queue – work that has not been done – the backlog or waiting list
This information will help identify variation in the system and allow teams to focus in on their problem area(s).
Having a data analyst to support you at this point would be very beneficial to help you understand what is causing your backlog.
Demand and capacity, a comprehensive guide – provides information on how to outline a process for demand and capacity modelling. This will allow you to carry out an initial analysis and how you can develop measures for longer term quality control.
Capacity calculator – a simple excel spreadsheet tool which, helps you to understand the time you have available for your main work activity, such as seeing a patient or managing a service.
NHS Fife outpatient capacity planning tool – allowed services to plan for the maximum capacity while ensuring physical distancing and safety precautions were in place throughout the COVID-19 outbreak.
Access QI – Maximising Service Capacity and Capability – Remobilising during COVID-19 requires elective care services to reassess their capacity and capability as they adjust to new circumstances. Innovations presented here illustrate how teams are using different tools and resources to deliver care in a sustainable manner.