Benefits Appraisal & Process Mapping eHealth Benefits Management Toolkit Benefits Appraisal & Process Mapping

Benefits Appraisal & Process MappingBenefits Appraisal & Process Mapping

eHealth Benefits Management Toolkit

Benefits Appraisal & Process Mapping.

2

Session Outline

Benefits Appraisal

Process Mapping

Next Steps

Benefits Appraisal & Process MappingBenefits Appraisal & Process Mapping3

Benefits Appraisal

Benefits Appraisal

Process Mapping

Next Steps


Motivation for Change: Sponsors and Enablers

Process & Role

Changes

System CapabilitiesBenefits

Clinical & Corporate Priorities

Resource Required:ENABLER/

OWNER

Resource Required:SPONSOR

Whose effort is required to ensure the benefits are achieved?

Who are the benefits important to?

Whose effort is required to ensure the benefits are achieved?

Who are the benefits important to?

Benefits Appraisal Process Mapping Next Steps


Benefit Enablers and Owners: Who needs to ensure that each benefit is achieved?

Whose working patterns will change if all benefits are realised?

What system capabilities enable these changes?

Whose working patterns will change if all benefits are realised?

What system capabilities enable these changes?



Benefit Owners: Who will need to mobilise change in their departments?

Who is responsible for ensuring that each change is translated to the operational line?

Who needs to lead the enablers of benefits?

Who is responsible for ensuring that each change is translated to the operational line?

Who needs to lead the enablers of benefits?



Benefit Enablers: Whose effort is required to ensure that each benefit is achieved?

Process and Role Changes Enabler(s)

Enter Process and Role Change Enter the people whose jobs will change if the system capabilities are used to their full potential.



Benefit Sponsors: Who are the benefits important to?

Who is responsible for ensuring that each clinical and corporate target is achieved?

Who is responsible for ensuring that each clinical and corporate target is achieved?



Benefit Sponsors: Who are the benefits important to?

Clinical/Corporate Priority Sponsor

Enter Clinical/Corporate Priority Enter the person who is responsible for ensuring that the target or priority is approved.



Evaluating Outcomes: Reviewing benefits identified in the previous session

Process & Role Changes

System CapabilitiesBenefits

Clinical & Corporate Priorities



Identified Benefits

CI RTM MI Benefit

✓ ✓ ✓ Enter Benefit Name

RTM: Real Time Management of the Patient JourneyCI: Clinical Information MI: Management Information



Identified Benefits

Are there any benefits to add or remove?

Do the benefits listed reflect the clinical/corporate priorities and the reasons why the project has been

undertaken?

Are there any benefits to add or remove?

Do the benefits listed reflect the clinical/corporate priorities and the reasons why the project has been

undertaken?



Appraisal of Benefits

Priority:

Some benefits are critical to patient care and the running of the department, while others will be useful, but not as crucial to improving key areas of care.

Likelihood:

Some benefits will be achieved simply by turning on the system, but some will have numerous dependencies or require intensive training to be realised.

ACTION:

Stick the benefits to appropriate section of the priority vs. likelihood matrix:

For the benefits that have been identified, how likely are they to be realised?

How important are they and to whom?

Priority:

Some benefits are critical to patient care and the running of the department, while others will be useful, but not as crucial to improving key areas of care.

Likelihood:

Some benefits will be achieved simply by turning on the system, but some will have numerous dependencies or require intensive training to be realised.

ACTION:

Stick the benefits to appropriate section of the priority vs. likelihood matrix:

For the benefits that have been identified, how likely are they to be realised?

How important are they and to whom?




Low Priority, Low Likelihood

Low Priority, High Likelihood

High Priority, High Likelihood

High Priority, Low Likelihood

Priority

Likelihood


FLAGSHIPFLAGSHIP

QUICK WINSQUICK WINSLOW RISKLOW RISK

HIGH RISKHIGH RISK


Why are the benefits important?

Benefits enable 6 aspects of process quality to deliver continually improved services:

Adapted from ‘Aims of Improvement’ Institute of Medicine, 2001


eHealth

Reliable

Appropriate

SafeSafe EffectiveEffective TimelyTimely EfficientEfficient EquitableEquitable Patient CenteredPatient Centered


eHealth enabled aspects of process qualityBenefits

Appraisal Process Mapping Next Steps

Avoiding injuries to patients from the care that is intended to help them.

Avoiding injuries to patients from the care that is intended to help them.

SafeSafe

Improved clinical decision making. Supporting use of multidisciplinary care guidelines. Enabling/ supporting clinical audit.

Improved clinical decision making. Supporting use of multidisciplinary care guidelines. Enabling/ supporting clinical audit.

EffectiveEffective

Avoiding waste, including waste of equipment, supplies, ideas, and energy. This includes duplication of information.

Avoiding waste, including waste of equipment, supplies, ideas, and energy. This includes duplication of information.

EfficientEfficient

Reducing waits and sometimes harmful delays for both those who receive and those who give care.

Reducing waits and sometimes harmful delays for both those who receive and those who give care.

TimelyTimely

Providing care that is respectful of, and responsive to individual patient preferences, needs, and values.

Providing care that is respectful of, and responsive to individual patient preferences, needs, and values.

PatientCentredPatientCentred

Providing care that does not vary in quality because of personal characteristics e.g gender, ethnicity, geographic location, socioeconomic status.

Providing care that does not vary in quality because of personal characteristics e.g gender, ethnicity, geographic location, socioeconomic status.

EquitableEquitable

Reduction in drug errorsElectronic dispensing Reduction in drug errorsElectronic dispensing

Provision of protocol driven pathways, that can be accessed electronically by all members of the multidisciplinary team

Provision of protocol driven pathways, that can be accessed electronically by all members of the multidisciplinary team

Shared appointment and scheduling systemsLinkage between systems reducing duplication of demographic and clinical information

Shared appointment and scheduling systemsLinkage between systems reducing duplication of demographic and clinical information

System will enable/support electronic immediate discharge summaries to be transmitted from hospital to GP

System will enable/support electronic immediate discharge summaries to be transmitted from hospital to GP

Reduction in cancelled appointments/ operations

Reduction in cancelled appointments/ operations

Will enable transfer of information from one healthcare professional to another, seamlessly crossing the interface between primary, secondary and tertiary care

Will enable transfer of information from one healthcare professional to another, seamlessly crossing the interface between primary, secondary and tertiary care

Description Example



ACTION:

For each benefit, and in particular those that are high priority on the priority vs. likelihood matrix, determine which of the quality dimensions they enable:

For the benefits that have been identified, how do they improve the delivery of services within NHSScotland?

ACTION:

For each benefit, and in particular those that are high priority on the priority vs. likelihood matrix, determine which of the quality dimensions they enable:

For the benefits that have been identified, how do they improve the delivery of services within NHSScotland?



Quality Dimension Count

Safe

Effective

Timely

Efficient

Patient-Centred

Equitable

Appraisal of Benefits:Opportunities to Improve Process Quality

Priority

Likelihood


Safe

Effective

Timely

Efficient

Patient-Centred

Equitable


Safe

Effective

Timely

Efficient

Patient-Centred

Equitable


Safe

Effective

Timely

Efficient

Patient-Centred

Equitable



What kind of impact does the system have on thedelivery of services?

Which improvements are jeopardised if thebenefits are not realised?

What kind of impact does the system have on thedelivery of services?

Which improvements are jeopardised if thebenefits are not realised?

Appraisal of Benefits:Opportunities to Improve Process Quality



Summary of Prioritisation Exercise

In this exercise, you have determined:

– the high risk benefits;

– whose effort is required to realise them; and,

– the kind of process improvements the benefits require.



Process Mapping

Benefits Appraisal

Process Mapping

Next Steps


Process MappingBenefits


There are guides available from the Improvement and Support Team in relation to process mapping, and this section of the Benefits Management Toolkit should be consider in addition to those.

Process mapping is important because it allows any changes to be understood across the whole pathway and therefore minimising negative disruption and maintaining quality of care during transition from current to future state.

There are guides available from the Improvement and Support Team in relation to process mapping, and this section of the Benefits Management Toolkit should be consider in addition to those.

Process mapping is important because it allows any changes to be understood across the whole pathway and therefore minimising negative disruption and maintaining quality of care during transition from current to future state.


Affected ProcessesBenefits


For each identified process and role change identified, what are the affected processes or pathways?

For each identified process and role change identified, what are the affected processes or pathways?


Which Processes Does the New System Enable?

Process and Role Change Process Mapped?

Enter name from Benefits Map Enter process or processes Yes/No



Affected Services

For each identified process and role change identified, what are the affected services?

For each identified process and role change identified, what are the affected services?



Which Services Does the New System Affect?

Process Services Affected Mapped?

Enter process name Enter services affected Yes/No



Complete the Current State Process Maps

Is there a current state process map for each of the affected processes?



Future State Processes:Reflect changes required to realise benefits

Are there any steps that must be shortened or removed? What system capabilities enable this?

X X

Change to process



Affected Roles

For each change to a process map, who is affected?For each change to a process map, who is affected?



Changes to Activities, Processes and Behaviours by Role

Role Changes to Working Practices

Enter role (Consultant, Junior Doctor, Charge Nurse, Technician, Porter, etc)

Enter changes to working practices (there may be several for each role)



Next Steps

Benefits Appraisal

Process Mapping

Next Steps


Approach to Rolling Out Changes

The change approach should include all activities needed to:

– address the issues identified;

– deliver the transformation required;

– build capability within the Service/ Board area to sustain the change and deliver future change through training and education;

– interventions may be delivered in a number of ways (e.g. dedicated internal team, external consultants, integrated team);

– there should be a single co-ordinating body to manage the change together; and,

– link interventions to the business case.

Typical areasTypical areas

Leading and directing changeLeading and directing change

Building and sustaining capabilityBuilding and sustaining capability

Communications and engagementCommunications and engagement

Delivering change and enabling benefitsDelivering change and enabling benefits



Effective Change

An effective programme of change requires the following attributes…

Absolute clarity of purpose

Widely understood &

compelling needClear

foundations for success & engaging to deliver

Reinforcement of the future

Bold, committed leadership

Support to deliver

Principles to drive

sustainable change

Measurable outcomes, aligned with strategic imperatives, cascaded responsibility

Measurable outcomes, aligned with strategic imperatives, cascaded responsibility

Power aligned with delivery responsibility; efficient governance;

effective co-ordination; no competing agenda; resourced to deliver (people and tools)

Power aligned with delivery responsibility; efficient governance;

effective co-ordination; no competing agenda; resourced to deliver (people and tools)

People understand exactly why the change is required and what the organisation will achieve by changing at

both the corporate and individual level

People understand exactly why the change is required and what the organisation will achieve by changing at

both the corporate and individual level

Readiness to take tough decisions and do what it takes to realise benefits; visible investment in the

change, supported by leadership, alignment,

tenacity

Readiness to take tough decisions and do what it takes to realise benefits; visible investment in the

change, supported by leadership, alignment,

tenacity

Understanding the history of change; developing the

behaviours to succeed; people are actively

engaged, compelled by, and involved in making the

change happen

Understanding the history of change; developing the

behaviours to succeed; people are actively

engaged, compelled by, and involved in making the

change happen

Locking delivery in to the organisation and rewarding it, managing resistance, building capable

managers and sustainable processes

Locking delivery in to the organisation and rewarding it, managing resistance, building capable

managers and sustainable processes



Targeted Areas for Change Activities

Leading and directing change:

– there may be requirements to assess the degree of leadership commitment and extent to which leadership will be able to deliver this project in the organisation; and,

– following this, some leadership development activity may be required.

Building and sustaining capability:– it is critical to develop skills and capability within the workforce that will enable people;

and,

– training and development support is likely to be required.

Communications and engagement:– communication and engagement are vital to build support for the project; and,

– input to develop and deliver communications and to manage stakeholders will be required.

Delivering change and enabling benefits:

– it is important to make the change happen and then sustain it through effective performance management; and,

– expertise in embedding new activities, tools and behaviours into existing performance management system will likely be needed.



Change Resources

What support will we need to meet our change challenge?

What are the high level requirements?

Leading and directing change Building and sustaining capability

Communications and engagement Delivering change and enabling benefits

What support will we need to meet our change challenge?

What are the high level requirements?

Leading and directing change Building and sustaining capability

Communications and engagement Delivering change and enabling benefits



Reporting on Success

Impact

– It is critical to demonstrate impact and success as the project is proceeding. In particular, engaging busy clinicians/managers in the project will be made substantially easier if early success stories can be demonstrated;

– eHealth Benefits Management Toolkit 'Benefits Definition & Measurement' demonstrates how qualitative and quantitative measures should be developed and baselines set;

– The whole team need to work closely together to measure the impact and identify the success stories;

– Refine the change strategy if the measures are not improving; and,

– Communicate successes continually.



Next Steps

– Get sign-off for revised process maps from sponsors, owners and enablers

– Target key individuals (enablers and sponsors) and build their involvement and buy-in for upcoming changes. Develop these individuals to become champions.

– Plan training and communications to coordinate with roll-out and deployment schedules and identify change leaders and their remits.

– Plan for detailed benefits profiling and benefits realisation planning.


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Documents

Benefits Appraisal & Process Mapping eHealth Benefits Management Toolkit Benefits Appraisal & Process Mapping