The Patient Journey
The words 'patient journey' are now being used all
across our local health sector.
Put simply, the 'patient journey' represents the
steps or process that a patient goes through as they receive health
care. It includes the entire patient experience: from first contact
through preventative or primary care, out-patient clinics,
hospitalisation and specialist care if necessary, and support services
back home. The journey may be short and direct in the event of a one-off
acute illness or surgical procedure; or protracted for people with a
chronic illness that requires management over many years, mostly outside
the hospital.
Improving the patient journey is not a one-off
project. It is a process of continuous quality improvement. To enable
this continuous process, we need to create an environment of learning
and renewal in which individuals and teams are encouraged to test
creative solutions to everyday challenges.
We don't have to get the solution right first
time, every time. Our long term goal is to eliminate duplication, delays
and potential for errors, and ensure that every step of the journey
improves outcomes for patients.
What needs improving?
In the Wairarapa, people generally receive high
quality health care that they value, but there is room for improvement.
Despite our best intentions we do not always
work in ways that have favourable outcomes for patients. The systems and
processes we use can sometimes interfere with providing quality care for
all patients. Improving the patient journey needs us to look much wider
than just the hospital care part of a patient's experience. It's about a
new way of thinking, a new way of doing things that requires a team
effort across the whole of the local health sector.
Many people and organisations contribute to the
delivery of health services in the Wairarapa. The quality, speed and
responsiveness of the patient journey are determined by how effectively
these different people and organisations work together.
Why are we doing this?
12 months after Wairarapa Hospital was built, an
extensive review was carried out (the post-implementation review). Four
key strategic improvement areas emerged. The common theme across all
four was a focus on improving the patient journey.
This 'patient journey' focus is vital because it
ensures that the four work-streams and all the smaller projects included
in each are coordinated, and ultimately focused on that one clear goal.
What are the four 'streams'?
The Patient Transfer work stream is at the heart
of improving the patient journey. It covers the many points of transfer
that can occur along the health care journey either between services, or
between levels of care. Eg: general practitioner (GP) to outpatients,
specialist, diagnostics, support services or the Emergency Department
(ED), ED to unit, ward or home, ward to theatre, rehab or home, referral
to a smoking cessation coach, hospital referral back to GP or to
tertiary services etc.
The three remaining inter-related work streams
facilitate and support the activities of the patient transfer. While
Patient Transfer focuses on care being shifted, Models of Care covers
the way in which teams deliver care to the patient within the hospital
setting.
Technology and Information covers how technology supports the way in which
care is delivered and communicated between all those involved in the
care process, both within and externally to the hospital.
Leadership is concerned with creating the right
environment to enable leaders to shine throughout all levels and places
in the local health sector.
Checklist for improving the patient journey
- Look at things from the patient's point of
view
- Find better ways of doing things
- Look at the whole picture
- Respect the ideas and work of others
- Make the best use of the skills of all
members of the healthcare team
- Empower and support everyone to create
solutions
- Take small steps as well as big leaps