A 'process' is a series of actions which are carried out to achieve a particular result, for example:
- How a service receives and manages referrals
- How letters are written and sent to service users
- How clinic appointments are booked.
All our services have a range of clinical and administrative processes in place, often supported by more detailed instructions (‘Standard Operating Procedures’ or ‘SOPs’).
Process improvement is where we review a process because we think things could be done more effectively.
Here are some tools which could help:
Process Mapping
A process map is a diagram putting into visual form the steps of a process. It can be created in a basic flowchart or in more detail (using swim lanes to represent different teams or services).
You may wish to begin process mapping at the start of a project or improvement. It can help you to understand how a process works and what the links are between teams or services. This can be useful in identifying who needs to be involved in the work and what data or other information might be needed.
Traditionally, specific shapes mean certain things on a process map – for example, a diamond usually represents a decision being made.
Learn more with our process mapping guide
2. Process Flow
When reviewing processes, it can be helpful to record the time it takes to complete each step in the process.
Looking at process flow helps:
- Understand how a process works in real-time
- Identify bottlenecks which delay the flow of a process or pathway
- Understand how a change to a process has affected its flow
- Click for more information about Process Flow
- Click for the process flow tool.
When you’ve completed the tool it gives you a visual representation of the time and resources needed to complete a process.
3. Value Stream Mapping
A value stream map (VSM) is similar to a process map, in that it displays the steps in a specific process. However VSMs usually:
- Go into more detail than process maps
- Emphasise which steps in the process add value (to the patient, service user or family)
- Include details of the time taken to complete each step and the number of tasks performed at each step.
You may decide to use value stream mapping when you need to:
- Identify the key roles responsible for the process and how they relate to each other
- Highlight how a process flows across team/service boundaries or functions/technology
- Identify potential process issues like reworking, duplication, excessive checking etc
- Identify the time taken at each stage and the volume of work going through the process.
Learn more about stream mapping here
4. Tools to identify process improvements
Here are some tools you may find helpful when reviewing processes in your team or service.
'TIMWOODS' is an acronym describing how processes can be wasteful – for example, a process which moves things around a lot can be considered to be wasteful in terms of Transportation. Another example is when colleagues have to queue to use the photocopier – this is wasteful in terms of Waiting.
Spaghetti diagrams can also help highlight how time, money and other resources can be used more effectively. A spaghetti diagram is a picture using a continuous line to show the physical journey someone or something goes on. It can be particularly useful to understand the experience a patient or service user may have on a clinical pathway, how clinical supplies are managed, or in considering how a referral is processed through the service.
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Cambridgeshire Community Services (CCS QI Community
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