This framework should be used in conjunction with the Evaluation of System Redesigns and Clinical Improvements and Pathway Audit frameworks.
Key questions or programme aims
Identification of System Redesigns and Clinical Improvements
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Key questions/Programme aims
What questions will identify if the programme is achieving its aims?
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Outcomes/Programme logic
What difference do we aim to make?
What do we expect to achieve?
Who will benefit?
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Indicators
How will we know if progress is tracking well?
What changes will we look for?
What indicators will help answer our key questions?
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Methods/Data sources
What data will we collect and how?
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Does the pathway conform with current and/or accepted local clinical best practice?
- Cross match pathway development, CWGs, data collection, and clinical stream evaluations with state and national health priorities over time
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- Log all issues being addressed via team/SME negotiation or CWG process
- Identify barriers and possible improvements
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- Review feedback
- 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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- Pathway audits
- Feedback:
- CWGs
- SMEs/CEs
- Clinicians
- Allied health
- HP programme team
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How were the service redesign opportunities identified?
- Has the catalyst for change been clearly identified?
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- Evaluate progress on the 'issues log' during pathway development and through the CWG process
- Identify barriers and possible improvements
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- Develop audits or surveys, and obtain baseline data for care within the clinical streams undergoing evaluation
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- Hospital metrics
- Referral audits
- Feedback:
- CWGs
- SMEs/CEs
- Clinicians
- Allied health
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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
- Clinician feedback
- 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 consequences of redesigns
- Review hypothetical patient outcomes (pre and post)
- Identify and rectify or mitigate any adverse outcomes before implementation
- Understand 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 audits
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