A Framework for Healthcare Provision Process Modelling

Research Theme: Healthcare Design

The healthcare system continues to struggle with the task of providing the right care to the right patient at the right time. Rather, it harms patients and frequently fails to deliver its potential benefits. The NHS is no exception. The NHS has devised several solutions for patient safety and is undergoing a period of significant change. However, it is of the utmost importance that these changes take place based on understanding of the whole system and the way they impact on patient safety.

Motivation

  • Around 425,000 patients (5% of total) admitted to hospitals in England and Wales each year experience adverse events from medical errors.
  • Error-prone organizations tolerate ambiguity, a prevailing lack of clarity over what is supposed to happen at any given time. Problems are thus hard to identify, and, even when recognized, they are worked around.
  • In the NHS, there is little in-depth understanding about how staff and patients use – and sometimes misuse

Objectives

  • To understand the characteristics of the healthcare system and the medicalerrors.
  • To provide the healthcare professionals with a usable modelling method forunderstanding the healthcare provision process.
  • To validate the usefulness of the healthcare process models

Method

  • Literature review
    Investigating accident and error models, risk analysis, and system modelling techniques applied in other safety-critical industries, and the nature of the healthcare system and the medical errors
  • Case studies
    Building process models using candidate modelling methods
  • Validation
    Evaluating the usability and usefulness of the modelling methods with healthcare professionals

Findings

The healthcare system is characterised as a collaborative system with distributed roles, complex data transfer, and limited centralised control. To represent such a system, various diagrams from Unified Modelling Language (UML) – e.g. class diagrams, collaboration diagrams, sequence diagrams, and activity diagrams – were needed to model various aspects of the healthcare processes. Usability and usefulness validations of these diagrams are planned.

Acknowledgements

  • Advisory support provided by: Hinchingbrooke NHS Trust.

Selected Publications

  • JUN, G.C ., WARD, J.R. and CLARKSON, P.J. (2005) 'Mapping the healthcareprocess in order to design for patient safety' in 15th International Conferenceon Engineering Design (ICED'05), Melbourne, Australia
  • BUCKLE, P., CLARKSON, P.J., COLEMAN, R., LANE, R., STUBBS, D., WARD, J.,JARRETT, J. and BOUND, J. (2003) 'Design for patient safety: a system-widedesign-led approach to tackling patient safety in the NHS', Department ofHealth Publications, London, ISBN 1-84182-765-7.