BCPSQC ForumEverything You Wanted to

Know About Patient Journey Mapping But Where Afraid to Ask!

PresentationMarch 8, 2012

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Overview of Our Time Together

1. Engagement of Patients

2. Engagement Exercise

3. Value Stream Mapping vs. Process Mapping

4. Patient Journey Mapping in Detail

5. Questions & Answers

6. Break

7. Patient Journey Mapping in BC

8. Patient Journey Mapping Exercise Exercise

9. Question & Answer Time

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We Hope You Will………

1. Be engaged

2. Be intrigued

3. Actively participate

4. Ask questions

5. Stay Awake

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Thanks and Acknowledgements

• BC MoH Patients as Partners

• Provincial Health Service Authority

• Regional Health Authorities

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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

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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…

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IPCC

PasP PartnersProvincialLinkages

UBCeHealth

Alzheimer’sSociety

Canadian MH Assoc.BC

ImpactBC

BCPSQC

BC Lung Assoc.

Pain BC

Heart & Stroke Fdn

U Vic Centre on Aging

HealthAuthoritiesHealth

AuthoritiesHealthAuthoritiesHealth

AuthoritiesHealthAuthoritiesHealth

Authorities

system & community

FirstLink

Bounce Back

program & service

individual

GPSC

Pt Journey Mapping

CSCs in Divisions

CDSMP

Matter of Balance

Active Choices

iCON forums

iCON resources

Health Talk Online

Arthritis Society

Family Caregivers

Network

Canadian DiabetesAssoc.

CHSRF-YVC CHSRF-YVC

Patients involved in PSP, Shared Care

Pt Self Mgmt, Health Literacy PSP module

CSCs in Divisions

HYH HYH HYH

PPE online

PPE online

PVN peer coaching

Pt Journey Mappingtraining and support

Patient Voices Network

Patient Voices Network

Talk to Your Doc

CHSRF-YVC

PPE online

PPE online

HYH HYH HYH

KEY

Shared CareCttee

patient involvement:PSP, TIC, PiC

Engagement

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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

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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.

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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.

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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.

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So, again…

• Patient Impact + Provider Willingness + Decision Latitude = Appropriate Level of Engagement

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Questions

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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

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Mapping, Mapping, Mapping

• Value Stream Mapping

• Process Mapping

• Patient Journey Mapping

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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

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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

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

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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

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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

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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

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What is Different?

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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!

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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.

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1. Overview of Patient Journey Mapping

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The Past

The focus was treating the condition

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Today

The Balance Family - 3 children with Type 1 DiabetesPhotograph by: Sharon Doucette, The Now Surrey, BC

Our Focus is the Whole Person

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Mapping

Is a tool to help us do just that

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