BCPSQC Forum Everything You Wanted to Know About Patient Journey

BCPSQC Forum
Everything You Wanted to Know
About Patient Journey Mapping But
Where Afraid to Ask!
Presentation
March 8, 2012
2
Overview of Our Time Together
1.
2.
3.
4.
5.
6.
7.
8.
9.
Engagement of Patients
Engagement Exercise
Value Stream Mapping vs. Process Mapping
Patient Journey Mapping in Detail
Questions & Answers
Break
Patient Journey Mapping in BC
Patient Journey Mapping Exercise Exercise
Question & Answer Time
3
We Hope You Will………
1. Be engaged
2. Be intrigued
3. Actively participate
4. Ask questions
5. Stay Awake
4
Thanks and Acknowledgements
• BC MoH Patients as Partners
• Provincial Health Service Authority
• Regional Health Authorities
5
Three Ways to do Health Care Improvement
• 1) Don’t listen very much to users and we do
the designing for them.
• 2) Listen to our users then go off and do the
designing for them.
• 3) Listen to our users and then go off with them
to do the designing together.
Paul Bate, 2007
6
Patients as Partners
It’s not a program of the MoH; it’s an initiative,
it’s a philosophy…
Nothing about me, without me.
The work happens through partnerships…
7
IPCC
CSCs in Divisions
CHSRF-YVC
KEY
Pt Journey Mapping
system &
community
CHSRF-YVC
Health Talk Online
program
& service
PPE online
iCON resources
Health
Health
Authorities
Health
Authorities
Health
Authorities
Health
Authorities
Health
Authorities
UBC
Authorities
eHealth
iCON forums
Family
Caregivers
Network
BCPSQC
PasP Partners
Provincial
Linkages
Alzheimer’s
Society
FirstLink
GPSC
Pt Self Mgmt, Health
Literacy PSP module
Patients involved in
PSP, Shared Care
CSCs in Divisions
HYH
HYH
Heart &
Stroke Fdn
Pain BC
Arthritis
Society
Canadian MH
Assoc.BC
BC Lung
Assoc.
Shared Care
Cttee
ImpactBC
CDSMP
Talk to Your Doc
Matter of
Balance
CHSRF-YVC
Active
Choices
Bounce Back
Canadian
Diabetes
Assoc.
HYH
patient involvement:
PSP, TIC, PiC
HYH
U Vic Centre
on Aging
individual
PPE online
HYH
HYH
PVN peer coaching
Patient Voices Network
PPE online
Pt Journey Mapping
training and support
PPE online
Patient Voices Network
Engagement
Empower
Collaborate
Involve
Consult
Solicit
feedback
on
Inform
proposals,
provide balanced alternatives
information to
and/or
increase
decisions
understanding
Work with
patient/public
to understand
and consider
concerns,
preferences
and values
9
Partner with the
public/patient in
each aspect of
decisionmaking,
including
identifying
alternatives and
preferred
solutions
Delegate
responsibility
for
identifying
issues,
solutions
and actions
to patients or
the public
10
11
What Level of Engagement is Appropriate?
Patient Impact + Provider Willingness + Decision
Latitude = Appropriate Level of Engagement
Its never too late to engage!
Focus Groups – Small Group Consultations –
Information Sessions – Newspaper Articles –
Surveys – Open Houses
12
Patient Impact
• Is the improvement to direct patient care or to a moment of
interaction between a provider and a patient?
• Will the change be controversial?
• Is it a change the patient will notice?
• Will your project change the experience of care?
• Will patients need to do anything differently?
• Will there be changes they can see?
• Will who gives them information change?
• If there is a strong impact on patient experience, it is
likely a deeper consultation (involve or collaborate) is
appropriate.
13
Provider Willingness
• Do providers and staff see the value in engaging
patients?
• What are the barriers to it they are articulating?
• Can you do anything about them?
• Are they real or “imagined”?
• If there is a low degree of provider willingness or high
logistical barriers, then a lower degree of consultation is
likely. This is the case regardless of the degree of affect
on patient experience.
14
Decision Latitude
• Is the decision on what to do complete?
• Is there room for review?
• How many factors are still open for discussion?
• A low level of decision latitude suggests either a
low level of engagement OR deeper
engagement on a narrower area.
15
So, again…
• Patient Impact + Provider Willingness + Decision
Latitude = Appropriate Level of Engagement
16
Questions
17
Engagement Exercise
• What project to improve a service or outcome is on top
of your pile?
• Using your handouts, evaluate this project for the
suitable level of patient/stakeholder/staff engagement.
• In groups of three, discuss barriers you see to carrying
out a suitable engagement. Can you see a way through
the barriers? What would it take to make engagement
possible? What prevents you from getting it?
Patient Impact + Provider Willingness + Decision Latitude =
Appropriate Level of Engagement
18
Mapping, Mapping, Mapping
• Value Stream Mapping
• Process Mapping
• Patient Journey Mapping
19
Value Stream Mapping
• A visual depiction of the processes that flow across the value stream
beginning to end
• Planning tool to identify and reduce/eliminate waste
• Provides a blueprint for improvement
• Sequence of process steps and time to complete each step
20
Value Stream
• Value Stream Mapping
–
–
–
–
Identifies value added and non value added steps
Visualizes complexity of system
Total time to complete steps
Allows for customer input
• Focus on service/product throughput
21
Process Mapping
 A visual depiction of the steps in a process
beginning to end
 A map to guide improvements
 Uses the techniques of flowcharting to
understand a process
22
Process Mapping
• Process Mapping
–
–
–
–
Visualizes complexity in a process
Identifies input, throughput, and output
No customer input
Looks at service/product delivery
• Focus on efficiency of process
23
Patient Journey Mapping
• A visual depiction of the patient’s journey
• Identifies the sequence of steps in the patient
journey
• Flowchart of information, and steps in process
• Helps guide improvement
24
Patient Journey Mapping
• Patient Journey Mapping:
–
–
–
–
Visualizes complexity of journey
Identifies the touch points in the patients care
Looks at how care is received
Patient voice paramount
• Focus on patient experience
25
What is Different?
26
27
Similar but Different?
• All three mapping techniques are similar
• Similarities include:
–
–
–
–
Identifying steps in the process
Looking at flows of information and communication
Visualize complexity of process or system
Identify improvements
• Difference
– VSM and Process Mapping focuses is on how care is delivered
– Patient Journey Mapping focuses is
on how care is received!
28
Patient Journey Mapping
Bringing together patients and all the key providers
across their journey for a full day session.
They map out, step by step, what actually
happens for a patient. Then they discuss where
improvement is needed and what can be done
about it.
“Journey” is defined explicitly from the patient
perspective.
29
1. Overview of Patient Journey Mapping
30
The Past
The focus was treating the condition
31
Today
The Balance Family - 3 children with Type 1 Diabetes
Photograph by: Sharon Doucette, The Now Surrey, BC
Our Focus is the Whole Person
32
Mapping
Is a tool to help us do just that
33