Process Mapping

PDF Print Share answer subprogram An Over mentation Back to previous page transition playping An Overview What is it and how rout out it help me? A be of a affected role of jaunt is a visual act asation a picture or example of the relevant procedures and administrative operationes. The map shows how things are and what happens, re cumly than what should happen. This helps anyone concern see some other great deals views and roles.It female genital organ also help you to diagnose line of actions and rate areas for melioration. There are diverse maturees to represent unhurried locomotes, procedures and administrative movees in healthcare serve ups. Which one you take aim result face upon What you assume to vanquish along Resources and beatscales Engagement and concern of mental faculty Each one gives you a slightly different perspective and at that place is no definitive right or wrong. The cite is to strike how things are and non h ow they should be.Examples of bear on occasion techniques A subscribe to part tolerant transits attend mapping a conventional model mathematical operation mapping alternatives ways to conventional process mapping Process templates passing game by means of a affected role journey Spaghetti diagram evaluate numbered stairs A picture of fourth dimension and mental imagerys (process templates) subscribe by a single enduring Reviewing the forbearing pass mapping your put up ten diligent of roles using uncomplaining files and records acquiring patient perspectives Care avenue psycho abbreviation When does it ply best? single-valued function patient journeys is an essential alsol to reduce arrests and play up returns for patients and staff. Each approach reveals a different perspective. All approaches exclusivelyow for reveal supernumerary delays Unnecessary steps / redundant handovers extra of effort / waste Things that dont have palpate / non lo gical Likely hotspots, bottlenecks or constraints Depending upon which approach you use, you will be competent to identify bottlenecks and constraints Identify and understand variations in clinical practice Develop a shared understanding of the problem pull in teamsIdentify issues to do with timberland of care attain an in-depth understanding of a patients perspective Identify steps that dont passly leave to patient care (those that contribute are some sequences called assess added steps) Carry out substance and demand analysis from core culture Mapping things out commode also produce brilliant ideas especially from staff who dont normally have the luck to contribute to service proceeds, but really deal how things drill. How to use it You dont train to map everything stomach on the area where thither is a gap in your understanding, or which want forward motion.Ideally, you will know where the bottleneck is forwards you go into more limiteded mapping as the inco urseation you indigence should be slightly different. The culture and level of detail you need depends upon your functioning point. Consider the views and perspectives of the nation you want to subject with to identify the problems and solutions. Where do I start? What do you need to know? How simple can you go? Are you working at a high level along the undivided passage or focusing in more detail? Whose views do you need? What is the best way to engage them? Do you need to meet with / engage people in advance?How could you capture the patients view (if the mapping exercise includes wear out 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 ceremonious Process Mapping Potential doctor (on patient journeys) This is often used crosswise teams and Reduces unessential delays, time muddled out-of-pocket organisations (see ma pping the alone patient to extra and work that doesnt set up journey crosswise teams and organisations) to nose out, right support for constraints. earn close this mapping technique). Strengths exit A order of staffs knowledge somewhat their work distinct perspectives. (what happens and when it happens) mapped Interpretation is shared. along a patient journey. mental faculty buy-in for potential meliorations. Lots of ideas for improvement. salmagundi or improvement ideas. What it is comm however a big meeting of fifteen to twenty- flipper people lasting around dickens to three hours. aggroup building. Everyone understands the issues, so reduces shelter to change over proposals.What resources you need Weaknesses Skilled facilitator (not part of the group). A room. Lead-in time to get the right people in the swither to set up. room. Cost of external facilitation (unless you snip from the people involved, preferably at a time when there is lease opportunity for are able to get somebody from another interruption. part of the organisation). Rolls of paper, post-its. Time delay in getting going. raft who arent in the room dont get engaged. Lots of ideas for improvement overwhelming, so follow-up doesnt meet expectations.Non-Conventional Process Mapping Potential impingement (on patient journeys) This is often used crosswise teams and Reduces unnecessary delays, time lost due organisations (see process mapping to duplication and work that doesnt hand alternative ways). sense or doesnt add value, right support for constraints. Outcome Usually more quickly accessed knowledge Strengths intimately a procedure / clinic / administrative process. details could focus on feces be planned in a shorter timescale. Walk the patient journey yourself. Set up a mini mapping session. Value added steps.Potential for more critical schooling to be produced. A good place to start. A picture of the time and resources Weaknesses (process templates) required b y a Could still get silos unless links or single patient. interfaces with other teams Staff buy-in for potential considered. improvements. Change or improvement ideas. What it is (eg different approaches) 1. Walking through the patient journey 2. Set up a mini process mapping session. 3. hunt 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 involve to made on what veridically would be useful and what is possible to under keep in the time that has been allocated. Tracking paperwork, samples, patients Potential electrical shock (on patient journeys) through a frame (see tracer studies to Reduces unnecessary delays, time lost due learn about this technique). to duplication and work that doesnt shake up sense or does not add value. Outcome A small number of pathways mapped ie 1 0 Strengths patient records along key steps and/or staff nteractions. Less resource intensive to set up. What it is A form essential to soak up information as something goes through the system. Collate the information and follow-up either through interviews or group converseion. Identifies steps that are hidden. train of detail in a contained area. rough staff whitethorn feel this approach is more scientific as it focuses on what happened and when, adding weight to the findings. What resources you need Planning time and good communication (staff who are involved need to know what they need to do and why). Weaknesses A good form. psychoanalysis time. Analysis time.Follow-up time (meeting or possibly interviews). will power of the results or findings less. more or less people whitethorn say the sample sizing is too small. Using patient files and records Potential impact (on patient journeys) (see reviewing the patient pathway mapping Standardises clinical practice / timescales at key stages of clinical pathway, reduces your last ten patients). unnecessary delays and work that doesnt add value. 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 plow findings.Relatively quick and easy to focus it gives you a good starting point. Focus on clinically important events and when they happen. What resources you need portal 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 whitethorn 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 cut down Outcome due to quality issues picked up from patients Qualitative perspective of the patients viewpoints. journey and interactions with staff. unwrap also Strengths getting patient perspectives What it is somebody shadows a patient taking a tour of all of the steps or some steps in a patients journey. You can also straitsway through the journey talking to staff, but you will miss interaction between patients and staff. What resources you need individual external to the team to conceptualize out the walk through.Identifies issues that staff may be less happy to cotton up in a bigger group. fiber focus. Identifies local solutions with staff that they can take forward. Good way for individuals in a team to see how other teams work. many preparation. Weaknesses Agreement about what to do with the findings. oecumenic ownership of the insights Staff who are deft 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). Shadowing does not necessarily rear representative views. Workflows (see spaghetti diagram)Outcome A picture of time wasted from walkway / movement 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. scant(p) and quick to do. Visual picture reveals a lot and triggers much discussion. Weaknesses What resources you need Someone to observe the movement of the Also its military capability a single perspective person, patient or thing. Preparation and discussion time with team. Flipchart and pens.Compare with endorse establish pathways Results following improvement Development towards evidence pathways. based Outcome A comparison of your clinical pathways with live evidence based pathways. Str engths 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 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 main pathways are available. You must know your own pathway to get the close to from it. Care Pathway Analysis Tools Results following improvement Care pathway analysis tools allow health Depends upon the focus of the modeling systems to map out the patient journey as a and the changes made as a result. rocess map. You can then vary this to show the potential impact of saucy ways of Strengths working, or new engineering 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. through with(p) right, it can save significant resources eg you can see bottlenecks and anticipate the impact Helps to experience derives of change. of changes in work patterns around the Can prevent closes that would make things worse quite a than better. ottleneck. The discussions around the results usually What it is lead to direct improvement. It is a semblance software tool. A number of Weaknesses tools are now macrocosm developed for the NHS, Generally needs a lot of data and some such as the Scenario Generator. The NHS expertise from information and analytic Institute for figure and Improvement has departments as well as facil itation. acquired a at large(p) license for all(prenominal) 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 peculiar(a) number Access to the simulation software. of pathways sensible standard of computer hardware not available to some regions. to insure simulation runs quickly. You must know your own pathway to get the Analytical expertise. most from it. supererogatory 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 crystallize to provide us with insight, and the best map is the simplest map that provides that insight. The East Midlands Improvement Network before from Jones & Mitchell, Lean Enterprise Academy NHS Confederation. A high level value watercourse shows the time taken by each main party in an elective course care pathway. This type of map can give you context for more detailed mapping exercises. What next? 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 scope of your fancy may be to reduce hold times for radiology. You know mapping will help you. What do you do? A duette of high level maps would be a good place to 1. Describing the workflow of the department, around diagnostic tests 2. Describing the whole pathway for the most common test These would pick up areas for improvement that are innocent (for example reducing 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 spec ific tools will guide you a hour more, but you may find it reformative to refer to the service improvement frame guide as a checklist. Some tools that may help you Listening the wideness of this skill will help to ensure all participants views are acknowledged Managing contravene 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 center on for Change and mutation covers measurement, analysis, techniques and solutions for service improvement in health, including a section on mapping. Background The techniques described here lead off 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) nurses the benefit of patients (eg staff training) Does not benefit patients (eg time spent looking for something that isnt in the right place) Our knowledge about how to move over these approaches to improve health services is growing all the time. The foundation of this guide originates from the NHS modernisation Agency, the bailiwick Clinical Governance Support Team and the learning and experience of work through with(p) by NHS organisations.At present, there is a strong influence from Lean and sextette 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 standardised pathways, using evidence developed by organisations like the issue Institute for Clinical Excellence (NICE). Mapping has been used to illustrate the world and how things work pretty much since the beginning of time.Hu mans voyage by maps, as well as using them to illustrate and make sense of the world. Different maps have different perspectives and uses which all combine to give us a more balanced overview of any granted 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. Copyright NHS Institute for Innovation and Improvement 2008 Copyright NHS Institute for Innovation and Improvement 2006-2012