Does the pathway conform with current best clinical practice?
- Latest guidelines
- National/state health priorities
- Locally accepted best practice
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- Identify if the pathway is clinically accurate and up to date:
- Reflects best practice and local agreement
- Contains accurate local referral information
- Log all issues being addressed via HP team/SME negotiation or the CWG process
- Identify barriers
- Identify possible improvements
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- Pathway-dependent
- Audit selected pathways for:
- Clinical quality
- Referral accuracy
- Review feedback
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- Pathway audits:
- Clinical audits
- Referral options
- Feedback:
- CWGs
- SMEs/CEs
- Clinicians
- HP programme team
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Has the wider health system been consulted, and feedback incorporated?
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- Resolve all identified issues or report them to the governance group, stakeholders, and/or CWGs
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- CWGs
- SMEs/CEs
- Clinicians
- Allied health
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- Interviews with key clinical and non-clinical leaders
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- Feedback from patient experience units
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Were a clinical valuation and impact assessment conducted before implementing the change?
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- Understand patient flow and the consequences of redesigns
- Review hypothetical patient outcomes (pre and post)
- Identify and rectify or mitigate any adverse outcomes before implementation
- Understand change impact on:
- Patient flow
- Patient journey
- The wider health system
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- Pathway-dependent
- Consider:
- Referral decline rates
- Quality of referral information
- First specialist assessment, surgery, and follow-up rates
- Wait times
- Did not attend (DNA) rates
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- Pseudo pathway – Analyse patient flow using a hypothetical pathway
- Referral audit
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Establish a data baseline
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- Develop audits and surveys, and obtain baseline data for care within the clinical streams undergoing evaluation
- Log all issues being addressed via team/SME negotiation or the CWG process
- Referral quality
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- Review feedback
- Pathway-dependent
- Consider:
- Referral decline rates
- First specialist assessment, surgery, and follow-up rates
- Quality of referral information
- Reduced testing
- Wait times
- Did not attend (DNA) rates
- Community care rates
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- Feedback:
- Key clinical and non-clinical leaders
- CWGs
- HP programme team
- Hospital metrics (pre and post)
- Referral audit (pre and post)
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What improvements or outcomes has the service redesign or clinical improvement made?
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- Improved:
- Patient outcomes
- Patient flow
- Health equity
- Clinical relationships (primary, secondary, tertiary)
- Reduced:
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- Pathway-dependent
- Consider:
- Referral quality
- Patient experience
- Resources used, e.g. testing
- Community care rates
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- Feedback:
- Allied health
- Hospitals
- SMEs/CEs
- Clinicians
- Health-system metrics
- Hospitals
- NGOs
- Allied health
- Referral audits
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Quantify the benefits of the change.
- Is the service aligned with best practice?
- Has referral quality improved?
- Have costs reduced?
- Has care in the community increased?
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- Identify improvements in:
- Referral quality
- E-referrals
- The wider health system
- Health equity
- Identify reduced variations of care
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- Review feedback
- Pathway-dependent
- Consider:
- Referral decline rates
- First specialist assessment, surgery, and follow-up rates
- Quality of referral information
- Reduced testing
- Wait times
- Did not attend (DNA) rates
- Community care rates
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- Feedback:
- Key clinical and non-clinical leaders
- CWGs
- HP programme team
- Hospital metrics (pre and post)
- Referral audit (pre and post)
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Has the patient journey improved?
- Has patient access to specialist care improved?
- Have patient outcomes improved?
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- Feedback from patient experience units
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- Hospital metrics (pre and post)
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- Qualitative feedback from clinicians
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- Surveys
- Interviews
- Feedback
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- Has patient access to specialist care improved?
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- Wait times
- Did not attend (DNA) rates
- First specialist assessment, surgery, and follow-up rates
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- Hospital metrics (pre and post)
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Review the outcomes and system redesign process
- Were the desired or expected outcomes achieved?
- What lessons were learned during the process? Can they be shared?
- Was this the correct approach?
- Would you change anything if you had to do it again?
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- Feedback from patient experience units
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- Impacts and outcomes
- Differences between the actual and pseudo pathway
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- Interviews with key clinical and non-clinical leaders
- Qualitative feedback from clinicians
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- Surveys
- Interviews
- Feedback:
- Allied health
- Hospitals
- SMEs/CEs
- Clinicians
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