A2.3. Process mapping

Process mapping

What should I expect the outcomes to be of using the tool?

  • Identification of improvement opportunities.
  • Action plan for how to maximise the benefits of identified improvement opportunities, including person(s) responsible, timeframes and governance arrangements.
  • Stop doing things that don’t add value which releases time to do value adding activity.
  • Improved staff morale and engagement by empowering staff to make changes to the things that cause them frustration in the work environment.

 

An overview:

 

Tool/ method

Everything that we do is a process from everyday simple activities for example making a cup of coffee to more complex tasks such as cooking Christmas dinner, every process can be improved and everything we do in our work environment is a process.

Processes are made up of tasks that are carried out in a set sequence to deliver a specified outcome

Your process map can be long and complex or short and simple for example referral to first appointment (short) or referral to discharge (long)

It can be used to map any process, particularly useful when different individuals or teams are involved in delivering a process where they don’t see the impact of their actions on other parts of the system.

It can be used to map the process as it is now (current state) and help you to map the process as it should be or you want it to be (future state).

It is a method for identifying value activities, waste and where improvements can be made. You may use your process map as a basis for developing a value stream map.

Why we may choose to use this tool/ method?

  • Process mapping is a simple exercise in your toolkit of improvements methods and is therefore suitable for teams at the start of their improvement journey.
  • It helps a team to know where to start making improvements that will have the biggest impact for the people using the service and for people delivering the service.
  • It is also useful to periodically revisit the improved process to check it is continuing to deliver the outcome you anticipated and identify any further improvements that could be made.

How you might use this tool/ method?

Resources – flipchart/wallpaper, post it notes, pens, sellotape, blu tack

Environment – you need a large wall space to be able to display the process, participants need to be able to view the whole of the map to identify improvement opportunities

Time required – a minimum of 2 hours 30 minutes to map and start the analysis

Involve – staff who are currently delivering the process, managers and other staff who are able to influence/have authority to make changes, where appropriate service users / patient involvement team particularly when mapping a patient journey

Preparation – gather data for the part of the process you are going to map, for example number of staff involved, number of referrals in to the process, any delays or waits before the work is processed.

 

Steps

 

Developing your Current State Map:

  • Agree the scope for the mapping – the start and the end point.
  • Team maps the process, identifying each step in the process recording each step on an individual post it note and placing it on the flipchart in order of sequence.
  • This maps your current process and identifies areas for improvement.

 

Develop your Future State Map:

Team analyses the process by considering the following questions:

  • Is the most appropriate person doing the task?
  • Is every one following the process as the flow chart shows?
  • Are there delays in the process?
  • What is the approximate time for each step?
  • Identify the tasks that add no value and/or are not needed (see Waste Wheel)?
  • Does the process support best practice guidance, NICE, CQC etc?
  • Are there queues or waiting lists along the process?
  • Does the step add benefit (value) to the process?

 

Using all this information now map what you would like the future state to look like. Detailing what the expected system should look like after improvements have been made.

 

Coloured post it notes are used to represent different parts of the process e.g. yellow for the key process steps, orange where information is needed from outside the process. Pink is used to identify issues/problems etc. (it depends what colours of post it notes you have).

What next?

  • PDSA cycle to test improvement ideas
  • Measure the impact of the changes you have made to provide evidence of the improvement.
  • More detailed mapping of sections of the process to identify further improvement opportunities
  • Development of standard operating procedures for part or all of the process
  • Training plan to standardise how staff deliver the process
  • Communication with stakeholders impacted by changes to the process
  • Celebrate success

 

Remember improvement is continuous therefore you may decide to repeat the process mapping if issues emerge with the new / improved system.

Examples/ case studies/ links to best practice/ evidence

Community Specialist and Special Care Dental Service, work across 3 geographically located teams.

Clinicians, administrative staff and service managers mapped their service from referral to completion of treatment for each of the service areas making visible that although they are delivering the same service they had more than 3 different ways of doing this. There was inequity in the length of time patients waited for treatment, and in some areas patients who could have received their treatment in a high street dentist were being referred in to the Specialist Dental Service and waiting for treatment . They were able to share best practice, standardise the process and are planning to pilot a central booking system to improve efficiency.

 

Examples of process mapping current states:

 

Current state - Emails

 

Current state - Meetings

 

A useful guide to mapping

Quality and service improvement tools: process mapping - an overview

Contact for further information

Rachael Davies, Cumbria Partnership NHS Foundation Trust
Rachael.Davies@cumbria.nhs.uk