Microsoft NHS Resource Centre - Process Modelling Community - Features

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Process Modelling Community Features

Introduction

Process mapping has become a well established means of discovering and developing processes in healthcare. Often developed in multi-disciplinary workshops, process maps are usually captured using paper roll, pen and sticky notes. The learning from such collaborative work is tremendous, but documenting, sharing and analysing the resulting maps can be challenging. Our main purpose is to promote and support the use of modern, standardised process modelling techniques across the NHS.

Why model processes?

Process modelling is about understanding how people (and the technologies they use) work together to achieve their goals. At the heart of process modelling is the assumption that we can describe what we do in our work as (more or less ordered) sequences of actions that have a common set of objectives. It is about the tasks we undertake, our goals, the rules we follow, the roles we assume, how we accept and pass on responsibility, how we communicate to achieve our objectives, what information we require, the resources we consume and the time we take to fulfil our activities.

Processes can vary in complexity, ranging from simple sequences of well prescribed tasks that can be performed with little or no variation (e.g. many simple procedures or protocols), to very much more complex practices that are subject to unpredictable variation and require the exercise of judgement (e.g. the practice of clinical care). It is not surprising to discover that process modelling approaches differ in their applicability to this spectrum of process types. Some are well suited to describing stable procedures, some are focussed on processes where computers play a substantial role, others are more suitable for modelling processes where human interaction is dominant, and a few can reflect more complex and dynamic situations.

However, all process modelling approaches can be used for the following purposes:

To discover

Healthcare is a complex endeavour so it is not surprising that few of us fully understand how our own efforts contribute to the ‘bigger picture’. The techniques of process mapping help us to discover all the steps taken to achieve a common goal (such as a care pathway). This will usually entail workshops that include representatives of all the roles involved in the process. Typically, steps are captured on sticky notes and arranged on a roll of paper on a wall.

Process modelling methods also generally start with workshops that include all relevant stakeholders, and an initial model may also be captured on paper or a white board. However, data about each step, that might be ignored or glossed over in process mapping, is gathered more systematically for process models, and specific approaches may be taken during workshops to ensure that the pertinent information is captured. These include the roles involved, details of waiting and execution times, volumes of activity, preconditions, outcomes and possible exceptions. The process is then drawn using a notation that reduces ambiguity and improves precision.

To design

Process mapping and modelling can of course both be used to design new processes. However, the use of process modelling notations encourages greater precision and clarity, and are less likely to be misinterpreted by whoever implements the design.

To inform

Process models that are represented in a standard notation on a computer can be shared easily not only with all staff involved in the process, but with other organisations and with software applications for drawing, checking and simulating the models.

To improve

Discovery of existing processes often reveals opportunities for their improvement that hadn’t been apparent beforehand. There might be duplication of activity, needless delays, steps that fail to contribute to the goal, or potential to run in parallel tasks that have been undertaken sequentially. Refining processes in this way should be a part of any continuous quality improvement system.

To transform

Process modelling alone cannot deliver transformational change but it is an important technique for design, planning and communication with stakeholders. Simulating models can increase confidence in the viability of new ways of working before taking the risk and bearing the cost of implementation.

To automate

Significant benefits can arise from automating repetitive tasks. Modelling the detail of processes is an essential first step to the design and implementation of automated systems. Business process management systems that can take a process model (using a standard notation) and run it are beginning to see widespread application in other sectors and whilst not yet in widespread use in healthcare, ours is undoubtedly a fertile ground for such applications.

To analyse

The more precise that a model of a process can be made, the greater the confidence that can be attached to any detailed analysis of its performance and behaviour. Once represented in a standard notation, a process may be used to develop a simulation model in which its performance and its response to changing external and internal factors can be explored.

Typical applications for process modelling and simulation in the NHS:

• Service improvement
• Efficiency gains by reducing needless effort or changes to roles
• Designing, testing and planning for new models of care or reconfiguration of services
• Documenting existing processes for sharing across multiple teams and organisations
• To inform financial and strategic planning and commissioning
• To examine the possible impact over time of changes to population, disease prevalence, service capacity or models of care provision