Practice Practice Pointer

Process mapping the patient journey: an introduction

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4078 (Published 13 August 2010) Cite this as: BMJ 2010;341:c4078
  1. Timothy M Trebble, consultant gastroenterologist1,
  2. Navjyot Hansi, CMT 21,
  3. Theresa Hydes, CMT 11,
  4. Melissa A Smith, specialist registrar2,
  5. Marc Baker, senior faculty member3
  1. 1Department of Gastroenterology, Portsmouth Hospitals Trust, Portsmouth PO6 3LY
  2. 2Department of Gastroenterology, Guy’s and St Thomas’ NHS Foundation Trust, London
  3. 3Lean Enterprise Academy, Ross-on-Wye, Hertfordshire
  1. Correspondence to: T M Trebble tim.trebble{at}porthosp.nhs.uk
  • Accepted 15 July 2010

Process mapping enables the reconfiguring of the patient journey from the patient’s perspective in order to improve quality of care and release resources. This paper provides a practical framework for using this versatile and simple technique in hospital.

Healthcare process mapping is a new and important form of clinical audit that examines how we manage the patient journey, using the patient’s perspective to identify problems and suggest improvements.1 2 We outline the steps involved in mapping the patient’s journey, as we believe that a basic understanding of this versatile and simple technique, and when and how to use it, is valuable to clinicians who are developing clinical services.

What information does process mapping provide and what is it used for?

Process mapping allows us to “see” and understand the patient’s experience3 by separating the management of a specific condition or treatment into a series of consecutive events or steps (activities, interventions, or staff interactions, for example). The sequence of these steps between two points (from admission to the accident and emergency department to discharge from the ward) can be viewed as a patient pathway or process of care.4

Improving the patient pathway involves the coordination of multidisciplinary practice, aiming to maximise clinical efficacy and efficiency by eliminating ineffective and unnecessary care.5 The data provided by process mapping can be used to redesign the patient pathway4 6 to improve the quality or efficiency of clinical management and to alter the focus of care towards activities most valued by the patient.

Process mapping has shown clinical benefit across a variety of specialties, multidisciplinary teams, and healthcare systems.7 8 9 The NHS Institute for Innovation and Improvement proposes a range of practical benefits using this approach (box 1).6

Box 1 Benefits of process mapping6

  • A starting point for an improvement project specific for your own place of work

  • Creating a culture of ownership, responsibility …

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