Visio star: Scottish project transforms process mapping
Process mapping is a way of finding out what is going on in an organisation - so problems can be ironed out. However, its flow charts and supporting documents can be hard to read. A Scottish project has changed all that for one NHS organisation. Lyn Whitfield reports.
Hospitals are complex places. Working out where people work and what they do can be difficult; working out how patients are meant to move through the system can be very difficult indeed. One reason this matters is that even a small change in one department can have a big impact on another.
Hospitals now have to meet a wide range of regulatory demands, government targets and financial challenges. So they are increasingly interested in finding out what those impacts are – and in making sure that patients are treated in the safest, fastest and most effective way possible.
Process mapping
One tool for finding out what is really going on is process mapping. This is a technique for finding out what people’s jobs are and how their work fits with the work of others in the system. It can also establish what materials, information and other inputs people are using.
“Mapping has been going on in the health service, but it has often been done using crude technology. We were using Microsoft Visio.”
The outcome is usually a flow chart, which provides a “bird’s eye view” of what is going on, plus other supporting documents. However, these can be hard to follow.
A partnership between a Scottish university and a Scottish health board has been looking at how to make them easier to understand, using Microsoft technology. The outcome is a new visual process mapping technique that could be offered to other NHS organisations.
Academics on the frontline
The project came about as the result of a Knowledge Transfer Partnership between the University of Stirling and NHS Fife. Knowledge Transfer Partnerships bring UK business and higher education together, and the one in Fife allowed a computing graduate to work full time with the NHS for three years, supported by university and health board staff.
Professor John Bowers, one of the people involved with the project, said it aimed to take the idea of process mapping, which is often used in a commercial environment, and adapt it to the specific needs of the NHS.
“Mapping has been going on in the health service, but it has often been done using crude technology,” he says. “We were using Microsoft’s Visio software to develop hierarchical models that allow people to look at an overview or to drill down into their specific bit of the process.”
“There is a lot of benefit to be gained from simply mapping and sharing information about what is going on.”
Visio is software that allows people to draw diagrams. These are built using Unified Modeling Language (UML), a graphical notation system that allows processes of various kinds to be recorded in standardised ways. Visio diagrams can be put online, and pictures and similar items imported from other Microsoft software packages.
In Fife, photographs were initially attached to the models to bring them to life. But the health board later invested in stylised pictograms; or graphical representations of jobs and functions. The result is a visual interface that staff can use to explore the models.
“There is a lot of benefit to be gained from simply mapping and sharing information about what is going on,” said Professor Bowers, who says the models have also been used practically to help new staff find their feet. However, they can also be used to find points at which services could be improved.
What if?
The models allow “what if” scenarios to be created. In other words, they allow changes to be made to see what impact they might have, without “real life” departments being affected.
“We have been doing some simulation work, for example in Accident and Emergency, where there is a real focus on meeting the four hour waiting time target,” says Professor Bowers. Other hospital departments that are interested include orthopaedics, which also faces strict waiting time targets.
The computing graduate, Mike Ghattas, also led a complementary project to redesign NHS Fife’s intranet portal to support this kind of service transformation. He has now been offered a job with the health board, which hopes to make the tools that have been developed available to other NHS organisations in Scotland.
“This work allowed us to tap into a valuable local knowledge base at the University of Stirling, which is at the cutting edge of thinking in this area,” said Ken Laurie, the director of strategic change at NHS Fife. “It has contributed to us achieving improvements in throughput and capacity in A&E and other clinical settings and is helping us to achieve national waiting time targets.”