Tuesday 12th June 2012
Genevieve Murphy, Macmillan Senior Learning and Development Manager, explains how ‘lean thinking’ is helping professionals transform the patient pathway.
In common with other regions, Northern Ireland is experiencing increasing pressures on its service delivery: a growing number of people living with cancer, new policy and service frameworks to comply with, and the severe economic pressure that so much of the world is experiencing.
Rather than merely react to this climate, the Macmillan Service Development team in Northern Ireland decided to take action. We wanted to develop a learning programme that would help Macmillan professionals plan and deliver improved patient pathways through service redesign.
Our preliminary research suggested the lean thinking model would be best suited to our purposes. The lean approach focuses on adding value to the service provided for patients, while removing elements that add no value. By concentrating on this simple focus, professionals tasked with leading service improvements can more clearly define the process that delivers value to users.
The lean approach also helps when looking at large-scale projects as a whole, by helping to hone in on the small but vital elements of a process, whether it is an enhanced waiting room layout, or a more efficient progress through the care pathway. So long as it entails a better experience for the service user, it’s within the scope of lean thinking.
We recruited participants from the five health trusts in Northern Ireland based on their involvement in service redesign. Amnis were selected to deliver the training. Specialists in strategic change, they are at the cutting edge of using lean and related service and quality improvement techniques within healthcare.
Participants took part in a four-day Accelerated Lean Skills Programme. The focus was on improving skills and techniques that aid creative and innovative design, and contributing to better service user care and experience.
Participants were required to develop an improvement project and design an implementation plan. They had access to learning groups or ‘sets’ where they received ongoing mentoring and consolidation of their learning, and help from their facilitator to overcome issues.
Finally, when they complete their improvement project they will write up and present their initiative, outlining methods and results. Feedback from the programme has been excellent.
Pat McClelland, General Manager for Cancer Services at Northern Trust, said, ‘This programme really helped me to clarify the initial steps to be taken, and helped define the projects we need to initiate in developing patient protocols for chemotherapy patients presenting in A&E.’
Colleen Harkin, Macmillan Palliative Care and Improvement Lead, commented, ‘This programme will be extremely beneficial in helping us transform a range of palliative care services and to implement new service improvement projects.’
The service team is currently engaged in two runs of the programme and early results have been very promising, with many new initiatives as a result. These include:
- A regional service improvement initiative to introduce a new model of breast cancer follow-up. It aims to improve the quality of people’s after-treatment experience, reduce inefficiencies in hospital follow-up, and enhance service coordination and integration.
- Transforming the existing welfare benefits service to a model that supports people at the acute phase of their diagnosis and treatment, or at end of life, and provides a managed referral to people with less acute needs to community advice services.
- An initiative to reduce the length of time patients are in the haematology unit and ensure an even spread of workload throughout the day.
- An initiative that reviews the inappropriate admittance at A&E of people residing in private nursing homes who are nearing the end of their lives. The initiative is reviewing the steps involved in the decision to transfer the patient and implementing good practice protocols and training.
The programme is approved by the Institute of Healthcare Management
and leads to an endorsed certificate and CPD points. The programme also qualifies participants as ‘Green Belts in Lean’ on completion of their project.
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Contact Genevieve Murphy, Macmillan Senior Learning and Development Manager, on 028 9070 8623
or email Genevieve