Thursday, 15 September 2011

A quick guide to clinical pathway mapping

Anyone associated with healthcare will be aware of the desirability of integrated pathways - joined up systems linking primary secondary, tertiary and community care. Accurate pathway mapping is a vital component for service improvement planning, patient safety enhancement and resource allocation. This will also be a key element for consideration by clinical commissioning groups and I hope that these groups will ensure that they either buy in this expertise or acquire it in house.

Mapping doesn’t need to be complicated and the success of any mapping exercise is gaining the consensus of all key stakeholders when agreeing best practice and operational methods and standards. As a delegate at one of my training programmes said ‘it’s a flow chart!’ Yes – it’s a flow chart – a carefully designed flow chart mapping crucial information.

Here is a quick summary on pathway design which may assist you when planning training and mapping exercises.

A clinical pathway map is a visual tool to help analyse, communicate, discuss and document clinical and care processes.

Macro map: The simplest, high level overview of how a process works.
Mini map:  A description of how a process works, giving more detail than a
macro level but avoiding micro detail, often focussing on a specific part of the macro plan. Every step within this map will represent a specific activity.
Micro map: This is an in depth analysis of the process in question, with every step representing an individual task

Uses of pathway maps in healthcare:
·         As a quality and service improvement tool (recommended by the NHS Institute for      
       Innovation and Improvement)
·         To map the patient journey and service processes
·         To assess clinical decision making
·         To capture detail along a pathway and identify problem areas
·         To assist with training and clarify complicated systems
·         To aid resource planning
·         As a vehicle for clinical discussion and service planning
·         As a risk analysis tool
·         To identify audit and measurement points
·         To identify service gaps and training needs
·         To list cost points

Considerations when planning a process mapping exercise:
·         Is this a paper exercise or do you need a process mapping event?
·         Whichever method you use, allow brainstorming time.
·         If you plan an event, invite all interested stakeholders
·         For any mapping event, a strong, independent and knowledgeable facilitator is essential 
      to ensure that you stay on track and everyone gets a chance to have their say.
·         Remember that many attendees may never have been involved with a mapping exercise
      so a training element to start the event is helpful.
·         Define the process you are mapping
·         Define the objective of creating the map – what are you hoping to learn or achieve?
·         Define start and end points (remember there can be more than one of each)
·         Agree the boundaries – what will be included, what will be excluded
·         Agree the level of detail you wish to map (ie. Macro, mini, micro)
·         Clarify whether a pathway is ‘as is’ or ‘as should be’ - do you need to map both scenarios?
·         Agree the way forward.
·         Try to produce clear and visually pleasing maps after the mapping exercise

In a perfect world:
Everyone associated with healthcare would understand the value of clinical pathway mapping and regularly revisit their systems to assess best practice and continue to improve services and efficiency.


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