Catherine Dale Programme Manager Patient Centred Care, King s Health Partners Cancer Centre & Lead, Experience Based Co-design Toolkit, The Kings Fund
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1 Mapping Patient Centred Pathways and Changing Ways of Working Catherine Dale Programme Manager Patient Centred Care, King s Health Partners Cancer Centre & Lead, Experience Based Co-design Toolkit, The Kings Fund November 2013
2 Overview A step by step guide to redesigning pathways from patients perspective, driving change, leading and monitoring improvement Assumes some understanding of process mapping from earlier sessions, introduces concepts from Experience-Based Co-Design (EBCD) particularly focusing on emotional mapping with examples 05/11/2013 Page 1
3 I process mapping 05/11/2013 Page 2
4 Process design: the boxes Urgent Referrals From GPs, 2ww,. Suspected cancers MTD meeting 8.30 Clinic starts 9.30am. Consultant and Oncologist Consultant registrar Patient sent for chest xray, FNA, other investigations Patient back to clinic to see D r Dieticians to see necessary follow - ups and ad - hoc new pat ients SALT to see appropriate patients Nurse Specialists sees patients new and follow - ups Patient leaves clinic with 2 week appt date? 05/11/2013 Page 3
5 What makes a good service: designing experiences Performance (P) How well it does the job/is fit for purpose Engineering + + (E) How safe, well engineered and reliable it is The Aesthetics of Experience (A) How the whole interaction with the product/service feels/is experienced Physical environment Human environment (Functionality & efficiency) (Safety) (Experience) Source: Bate & Robert, /11/2013 Page 4
6 Experience-based co-design Gather experience information: observations, interviews (films) with staff and patients Prioritise and agree key issues Patients and staff co-design solutions together 05/11/2013 Page 5
7 Where we used the EBCD approach: Breast and lung cancer services Colorectal and gynaecological cancer Not just cancer - other applications: A&E departments (Australia) Mental health hospital and community settings (SLAM) Our EBCD work has led to: A co-design approach to patient involvement and service improvement Practical toolkit: 05/11/2013 Page 6
8 I process mapping 05/11/2013 Page 7
9 Process design: the boxes Urgent Referrals From GPs, 2ww,. Suspected cancers MTD meeting 8.30 Clinic starts 9.30am. Consultant and Oncologist Consultant registrar Patient sent for chest xray, FNA, other investigations Patient back to clinic to see D r Dieticians to see necessary follow - ups and ad - hoc new pat ients SALT to see appropriate patients Nurse Specialists sees patients new and follow - ups Patient leaves clinic with 2 week appt date? 05/11/2013 Page 8
10 Experience design: the bubbles Always long delays, afraid to go to toilet Bombarded with letter after letter Car parking Urgent Referrals internal, Hemel, St. Albans, GPs, 2WW, suspected cancers MTD meeting 8.30 Clinic starts 9.30am. Consultant and Oncologist Consultant registrar Drowning in forms and paperwork Patient sent for chest xray, FNA, other investigations Breaking the bad news moment Patient back to clinic to see Dr Dieticians to see necessary follow-ups and ad-hoc new patients SALT to see appropriate patients Nurse Specialists sees patients new and follow-ups Patient leaves clinic with 2 week appt date? Lost and confused The weighing scales on a computer 05/11/2013 Page 9
11 I emotional mapping 05/11/2013 Page 10
12 I emotional mapping 05/11/2013 Page 11
13 Touch point Vulnerable Numb Apprehensive Powerless 05/11/2013 Page 12
14 Key issues in patient s words appointments I don t want to have to manage my appointments communication I don t want to be left in the dark about what is going on day surgery I don t want to feel like I m on a conveyor belt end of treatment I don t want to feel dropped after my treatment Don t forget the co-design staff and patients work on the solution together 05/11/2013 Page 13
15 A story of successes Efficiencies Experience Raising awareness 2 years on: 39 out of 56 solutions (66%) were found to have been sustained 05/11/2013 Page 14
16 Further information: 05/11/2013 Page 15
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