E9 Mary Sawan - Patient Journey Mapping The Northern Way
Transcript of E9 Mary Sawan - Patient Journey Mapping The Northern Way
Mary Sawan M.Ed, Quality Improvement Lead, NI
Patient Journey Mapping
The Northern Way
the northern way of caring
the northern way of caring
Types of Mapping
There are many ways to map
In the North we took the best of what was
available in the literature and put a
“Northern” spin on the work.
the northern way of caring
Where We Have Been
Frail Elderly Patient and Family – Home
and Community Care
Blood Bourne Pathogens – [HIV/AIDS]
Adult Mental Health and Addictions
Aboriginal Adult Mental Health and
Addictions
Peri-natal [Pending]
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Improvement On Mapping
We began to work with marginalized
populations whose experiences were not
effectively being captured by the
traditional mapping
We wanted to improve upon the mapping
process by capturing the raw emotions of
patients
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Traditional Mapping
Creates a visual representation of every
step taken by a patient as they move
through the system
Can be seen as linear and process
focussed
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Emotion Focused Mapping
Creates a visual representation of every
step taken by a patient
and
their emotional reaction as they move
through the system
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Emotional Reaction
How did you feel?
This question is asked at each intersection
point and in addition the patient is asked
about their emotional reaction to the
wait times throughout their journey
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Why is the emotional
journey important to map
and capture?
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Traditional Mapping
The map does not represent one patient’s
experience but a typical experience of a
hypothetical patient
The goal is to map what happens 80% of
the time
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Emotion Focused Mapping
The map is specific to an individual
patient and their unique journey through
the system
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Emotion Focused Mapping cont’d
We use multiple patients and their stories
to verify the system and process
examine themes in the system
Examine themes amongst the patient
experience
Identify gaps in care that are not process
related [ how we greet patients, eye contact,
tone. ]
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Emotional Focussed cont’d
Some of the gaps described by the patient
can be quick fixes that the system did not
always recognize as a problem.
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Briefing the Patients
In order for patients to feel comfortable sharing
their story we brief them before the event
– We let them know who will be in the room
– We assure them that even if they have something negative
to say about their experience or care that they will still
receive services
– We let patients know that this is not a debate and that their
story and journey is their own and will not be debated by
the providers in the room
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Briefing the Providers
We prepare providers to hear positive and
negative reactions to some of the care
that they have been part of
We indicate to providers that this is not
the proper forum to debate a patients
journey or experience
Providers are there to hear the story
being told to them and see the system
from the patient’s experience
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This is How We Do It
Brief the patients
We separate the room: providers are at the back
of the room, patients sit front and center
We facilitate in pairs – one mapping, the other
facilitating and facing the patient listening to
patients story and asking the questions
We write the emotions expressed on post its and
apply them appropriately to the journey
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This is How We Do It - Continued
We debrief the patients in another room
after the mapping sessions to ensure
safety
In addition the providers are debriefed in
another room
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This is How We Do It - Continued
We reunite with patients after the maps have
been entered into Visio to validate their stories
before sharing with the larger group
We hold a follow up meeting with patients and
providers to discuss and celebrate the changes
that have occurred due to the lessons learned
from their journey
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Debrief and Validation
After the mapping session patients and/or
caregivers are debriefed
All maps are validated by the patients
before brought to system providers
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Follow Up
After we have brought the system maps to
the providers and changes have occurred
(or PDSA cycles are ramping) we bring
patients and/or caregivers back for follow
up
Here we inform patients how their story
and their suggestions have lead to change
to help support the patient journey
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What We Have Discovered
Briefing patients puts them at ease and
allows them to tell all parts of their
journey – good and bad
Debriefing patients ensures that we do no
harm
Providers report learning from hearing
patients stories and many providers are
emotionally impacted by what they hear –
this encourages change and engagement
with the changes
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What We Have Discovered
Patients LOVE to be heard
Patients enjoy the celebration day as a
way to tie up what they have contributed
to
Hearing the exceptions provides deeper
understanding to marginalized patients
and the changes necessary to create a
level playing field for ALL Northerners
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