The ‘Integrated Patient Journey Map’: A Design Tool for Embedding the Pillars of Quality in Healthcare Solutions

IPJM offers a constructive tool for multi-disciplinary teams to work together in designing healthcare solutions, through mapping the physical and emotional journey of patients for both the current service and the proposed service reform. It supports groups in understanding and negotiating the conflicting requirements that can arise during transformational projects. This is achieved using journey mapping and user personas for graphically externalising key domain knowledge.

Innovation Summary

Innovation Overview

Health information technology (HIT) and associated data analytics offer significant opportunities for tackling some of the more complex challenges currently facing the healthcare sector. However, in order to deliver robust healthcare service improvements, it is essential that the design of HIT solutions considers in parallel the three core pillars of healthcare quality - clinical effectiveness, patient safety, and patient experience. This requires multidisciplinary teams to design and evaluate interventions that both adhere to medical protocols but also achieve the tripartite goals of effectiveness, safety and experience.

In this case study, a tool that has been developed during a healthcare project called LEANBH using a human-centred design research approach is described. The ‘Integrated Patient Journey Map’ (IPJM) assists multidisciplinary teams in designing effective healthcare solutions to address the three core pillars of healthcare quality. IPJM is unique in addressing the shortcomings of existing methodologies by supporting multidisciplinary practitioners working together using a visual tool to design healthcare solutions that consider not one but all three of Patient Persona, Patient Journey and Medical Pathway. This helps to ensure that the designed services meet the demands of existing constraints, performance improvement, and patient experience. Findings suggest that IPJM supports groups in understanding and negotiating the conflicting requirements that can arise during transformational projects. This is achieved using journey mapping and user personas for graphically externalising key domain knowledge. IPJM also promotes creative thinking around service reform goals and fosters dialogue among stakeholders, potentially leading to better solutions overall.

The LEANBH project team used IPJM during successive workshops to superimpose the journeys of fictional personas of different expectant mothers who would use the connected health service. Eight fictional personas were identified by the team to represent the different hypertensive disorders that can occur during pregnancy and the medical scenarios which can occur. This included ‘Sheila’, a 31-year old first-time expectant mother at risk of hypertension during pregnancy due to a family history of pre-eclampsia. Her journey through the standard antenatal pathway was now complemented with her use of the proposed connected health solution. Other personas included ‘Denise’, a 25-year old expectant mother who developed pre-eclampsia, and ‘Fiona’ a 29-year old expectant mother who developed gestational hypertension.

IPJM challenged the siloed thinking of both the clinical and IT subgroups. Individuals would often speak out on behalf of one of the personas and assert how certain decisions would affect the physical and emotional journey of this expectant mother. One powerful example of this emerged during discussions around the journey of ‘Brenda’, an expectant mother who (due to white-coat syndrome) is incorrectly diagnosed with gestational hypertension and admitted to the hospital. The group discussed the emotional impact this event would have on Brenda and challenged itself to come up with ways in which the connected health platform could be designed to avoid the unnecessary hospitalisation of Brenda.

As stated by the project manager, these activities represented a significant milestone where: “technical concerns and clinician concerns were starting to be addressed as a unit as opposed to being two separate entities… For the first time people realised that the journey wasn’t a clinical journey, it wasn’t a medical journey, but neither was it a technological journey. It was all combined together”.

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Year: 2015
Level of government: Regional/State government

Status:

  • Identifying or Discovering Problems or Opportunities - learning where and how an innovative response is needed
  • Generating Ideas or Designing Solutions - finding and filtering ideas to respond to the problem or opportunity
  • Developing Proposals - turning ideas into business cases that can be assessed and acted on
  • Implementation - making the innovation happen

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