Process Mapping

PDF Print Sh atomic number 18 summons chromosome stageping An Overview Back to previous page bear upon chromosome correspondping An Overview What is it and how give the sack it help me? A map of a longanimous journey is a visual representation a yield or model of the applicable procedures and administrative biddinges. The map shows how things atomic number 18 and what happens, rather than what should happen. This helps any maven involved contain some other(a) heaps views and roles.It come outhouse also help you to diagnose problems and identify areas for improvement. There are different liftes to map forbearing journeys, procedures and administrative processes in healthcare services. Which one you select will depend upon What you need to subsist Resources and quantifyscales Engagement and pertain of staff Each one gives you a slightly different spot and there is no definitive flop or wrong. The key is to polish how things are and non how they shoul d be.Examples of process use techniques A guidebook to mapping diligent journeys process mapping a conventional model Process mapping alternates ways to conventional process mapping Process templates Walkthrough a patient journey Spaghetti diagram Value enlargeed steps A mental picture of cartridge holder and options (process templates) required by a single patient Reviewing the patient pass mapping your last ten patients using patient files and records acquire patient spots Care path compendium When does it take form best?Mapping patient journeys is an essential tool to reduce delays and cotton up improvements for patients and staff. Each barbel reveals a different perspective. All get ones will reveal unessential delays Unnecessary steps / unessential handovers Duplication of effort / waste Things that dont make sense / not logical Likely hotspots, bottlenecks or constraints Depending upon which approach you use, you will be able to secernate bottlenecks an d constraints Identify and understand variations in clinical abbreviate along Develop a shared understanding of the problem Build teamsIdentify issues to do with quality of care Gain an in-depth understanding of a patients perspective Identify steps that dont directly transmit to patient care (those that contribute are some prison bounds called value minimal brain damageed steps) Carry emerge capacity and demand summary from core information Mapping things out screwing also levy brilliant ideas especially from staff who dont normally need the opportunity to contribute to service improvement, but really sock how things construct. How to use it You dont need to map everything concentrate on the area where there is a gap in your understanding, or which needs improvement.Ideally, you will chouse where the bottleneck is before you go into to a greater extent flesh out mapping as the information you need should be slightly different. The information and level of position y ou need depends upon your runnering point. meditate the views and perspectives of the flock you want to black market with to identify the problems and solutions. Where do I sustain? What do you need to know? How simple can you go? are you releaseing at a lofty level along the consentient pathway or focusing in more(prenominal) detail? Whose views do you need? What is the best way to engage them? Do you need to hurt with / engage people in advance?How could you capture the patients view (if the mapping exercise includes part of the service they experience)? Wherever possible, use photographs and pictures of places, staff and equipment in mapping exercises. This brings your representation of how things are to life. Guide to Conventional Process Mapping probable impact (on patient journeys) This is oft used across teams and Reduces unnecessary delays, measure lost due organisations (see mapping the whole patient to duplication and race that doesnt make journey across tea ms and organisations) to sense, right moderate for constraints. earn astir(predicate) this mapping technique). Strengths Outcome A range of staffs familiarity close to their bend Different perspectives. (what happens and when it happens) mapped Interpretation is shared. along a patient journey. Staff buy-in for likely improvements. Lots of ideas for improvement. Change or improvement ideas. What it is Usually a larger-than-life concussion of fifteen to twenty- five people lasting around ii to three hours. Team building. Everyone understands the issues, so reduces resistance to change proposals.What resources you need Weaknesses aptitudeed facilitator (not part of the group). A room. Lead-in conviction to get the right people in the Effort to set up. room. Cost of external facilitation (unless you sentence from the people involved, preferably at a metre when there is lease opportunity for are able to get someone from another interruption. part of the organisation). Roll s of paper, post-its. Time delay in getting button. People who arent in the room dont get engaged. Lots of ideas for improvement overwhelming, so follow-up doesnt meet expectations.Non-Conventional Process Mapping authorization impact (on patient journeys) This is often used across teams and Reduces unnecessary delays, season lost due organisations (see process mapping to duplication and work that doesnt make alternative ways). sense or doesnt add value, right support for constraints. Outcome Usually more quickly accessed knowledge Strengths about a procedure / clinic / administrative process. Details could focus on Can be planned in a shorter timescale. Walk the patient journey yourself. tog up a mini mapping session. Value added steps.Potential for more detailed information to be produced. A good place to start. A picture of the time and resources Weaknesses (process templates) required by a Could still get silos unless cogitate or single patient. interfaces with other team s Staff buy-in for potential considered. improvements. Change or improvement ideas. What it is (eg different approaches) 1. Walking through the patient journey 2. do up a mini process mapping session. 3. Follow a patient. 4. Be a patient . What resources you need Clipboard and paper (if doing it by yourself) or flipcharts, rolls of paper and post its. onsidered. Just because there is more detail, it does not (and should) not reflect everything. A judgement call needs to made on what actually would be useful and what is possible to undertake in the time that has been allocated. Tracking paperwork, samples, patients Potential impact (on patient journeys) through a outline (see tracer studies to Reduces unnecessary delays, time lost due learn about this technique). to duplication and work that doesnt make sense or does not add value. Outcome A small number of pathways mapped ie 10 Strengths patient records along key steps and/or staff nteractions. Less resource intensive to set up. W hat it is A form authentic to pick up information as something goes through the system. Collate the information and follow-up either through interviews or group discussion. Identifies steps that are hidden. Level of detail in a contained area. Some staff may feel this approach is more scientific as it focuses on what happened and when, adding weight to the interpretings. What resources you need formulation time and good communication (staff who are involved need to know what they need to do and wherefore). Weaknesses A good form. Analysis time. Analysis time.Follow-up time (meeting or possibly interviews). Ownership of the results or findings less. Some people may say the sample size is too small. Using patient files and records Potential impact (on patient journeys) (see reviewing the patient pathway mapping Standardises clinical practice session / timescales at key stages of clinical pathway, reduces your last ten patients). unnecessary delays and work that doesnt add valu e. Outcome 10 records of patient journeys with timescales Strengths from a defined start and end point. What it is A review of patient records and a follow-up meeting to discuss findings.Relatively quick and easy to focus it gives you a good start point. Focus on clinically important events and when they happen. What resources you need Access to patient records (this isnt always Comparison across consultant. easy). Time to review the patient records. A room and the right people to discuss the Weaknesses results. Misses out the detail. Misses out the why things happen. People may say the sample size is too small. Walkthrough a patient journey / patient Potential impact (on patient journeys) shadowing (see process mapping Reduces unnecessary delays, time lost due alternative ways). o duplication and work that doesnt make sense or doesnt add value. Delays reduced Outcome due to quality issues picked up from patients Qualitative perspective of the patients viewpoints. journey and i nteractions with staff. See also Strengths getting patient perspectives What it is Someone shadows a patient taking a tour of all of the steps or some steps in a patients journey. You can also take the air through the journey talking to staff, but you will miss interaction between patients and staff. What resources you need Someone external to the team to carry out the strait through.Identifies issues that staff may be less happy to highlight in a bigger group. Quality focus. Identifies local solutions with staff that they can take forward. Good way for individuals in a team to see how other teams work. Some preparation. Weaknesses Agreement about what to do with the findings. General self-possession of the insights Staff who are skilled at observing / gained (it is recommended someone interviewing doing the walk through. Permission from patients. external to the team does the walk Time to write it up. through). shadow does not necessarily provide representative views. Workflows (see spaghetti diagram)Outcome A picture of time wasted from walking / lawsuit of things. Strengths What it is A picture of the actual movement of staff, patients or things eg X-rays through a department. Called a spaghetti diagram as thats what it often looks like. Results of improvements Better layout for a department or ward establish on observations. Easy and quick to do. Visual picture reveals a lot and triggers overmuch discussion. Weaknesses What resources you need Someone to observe the movement of the Also its strength a single perspective person, patient or thing. Preparation and discussion time with team. Flipchart and pens.Compare with essay ground pathways Results following improvement Development towards evidence pathways. base Outcome A comparison of your clinical pathways with existing evidence based pathways. Strengths What it is Uses existing pathway work as a source of knowledge and ideas, links to pathway work Focus on evidence based care and best practice . Simple vision for the future. Map of practice of medicine may get people on the same page. Delivering quality and value cancer Services Collaborative Partnership Department of Health 18 week programme Weaknesses NHS Library Protocols and Pathways What resources you need Preparation.Access to the existing pathway. Meeting room and time with the right people. Flipchart. A focus on right patient, right care, right time (Source local evidence) May not pick up the reality of what is going on in your pathway (especially in support function).. Currently, only important pathways are available. You must know your own pathway to get the nigh from it. Care Pathway Analysis Tools Results following improvement Care pathway analysis tools allow health Depends upon the focus of the pretending systems to map out the patient journey as a and the changes made as a result. rocess map. You can then modify this to show the potential impact of impudently ways of Strengths working, or new techno logy and practice (see care pathway analysis). Displays ideas for improvement and potential impact without need to make What you get from the analysis actual changes on the ground. The anticipated impact prior to change. Done right, it can save significant resources eg you can see bottlenecks and anticipate the impact Helps to pick up bring ins of change. of changes in work patterns around the Can prevent decisions that would make things worse rather than better. ottleneck. The discussions around the results usually What it is lead to direct improvement. It is a simulation software tool. A number of Weaknesses tools are now being poseed for the NHS, Generally needs a lot of data and some much(prenominal) as the Scenario Generator. The NHS expertise from information and analytical comprise for Innovation and betterment has departments as closely as facilitation. acquired a free license for separately SHA and All models represent a view of the world. The PCT. impact the model simulates may not be what happens.What resources you need Currently, free tools only have exceptional number Access to the simulation software. of pathways Reasonable standard of computer ironware Not available to some regions. to ensure simulation runs quickly. You must know your own pathway to get the Analytical expertise. most from it. Additional data. Meetings to develop your model. Good understanding about the strengths and limitations of the approach. Examples We want the simplest possible picture of how the process works, and simplest is the key word here.The aim of process mapping is to make things loose to provide us with insight, and the best map is the simplest map that provides that insight. The East Midlands return Network Originally from Jones &038 Mitchell, Lean Enterprise Academy NHS Confederation. A high level value stream shows the time taken by each(prenominal) main party in an elective care pathway. This type of map can give you context for more detailed mapping exercises. What close? Be clear about your focus. If you are starting out, select an approach that will give you an overview of the whole pathway. Try to get an experienced facilitator on board to help you out.Be clear about your objectives, ie ask what, why, when, where and how? For example, the stage setting of your project may be to reduce waiting times for radiology. You know mapping will help you. What do you do? A pair of high level maps would be a good place to 1. Describing the workflow of the department, around diagnostic raises 2. Describing the whole pathway for the most common test These would pick up areas for improvement that are straightforward (for example cut down the number of handovers) and may also pick up problem areas for more detailed mapping exercises.You should make improvements before you get to the next stage. The detail tools will guide you a bit more, but you may find it helpful to refer to the service improvement project guide as a check list. Some tools that may help you Listening the importance of this skill will help to ensure all participants views are acknowledged Managing conflict may help with resistance to change Additional resources Websites Map of Medicine Map of Medicine is linked to Connecting for Health and is currently available to organisations in the english NHS.NHS Scotlands Centre for Change and Innovation covers measurement, analysis, techniques and solutions for service improvement in health, including a section on mapping. Background The techniques described here bug out in the main from the manufacturing industry, with a couple from social sciences. For example, the emphasis and term value stream mapping comes from an approach called Lean.Directly translated to health, this separates and maps out procedures and work processes that Directly benefit patients (hands on time, decision making) Supports the benefit of patients (eg staff training) Does not benefit patients (eg time spent looking fo r something that isnt in the right place) Our knowledge about how to engage these approaches to improve health services is developing all the time. The foundation of this guide originates from the NHS Modernisation Agency, the internal Clinical Governance Support Team and the acquirement and experience of work done by NHS organisations.At present, there is a impregnable influence from Lean and Six Sigma approaches to mapping pathways, procedures and work processes in healthcare. The other strong influence on health services is the development of evidence based clinical pathways. These are being developed as similar pathways, using evidence developed by organisations like the National Institute for Clinical Excellence (NICE). Mapping has been used to illustrate the world and how things work pretty much since the beginning of time.Humans navigate by maps, as well as using them to illustrate and make sense of the world. Different maps have different perspectives and uses which al l combine to give us a more balanced overview of any given situation. Acknowledgements / sources The foundation of this guide originates from the NHS Modernisation Agency, the National Clinical Governance Support Team and the learning and experience of work done by NHS organisations. procure NHS Institute for Innovation and Improvement 2008 Copyright NHS Institute for Innovation and Improvement 2006-2012