1. Benefits Appraisal & Process Mapping eHealth Benefits Management Toolkit Benefits Appraisal & Process Mapping.

2. 2 Session Outline Benefits Appraisal Process Mapping Next Steps

3. Benefits Appraisal & Process Mapping 3 Benefits Appraisal Process Mapping Next Steps

4. Benefits Appraisal & Process Mapping Motivation for Change: Sponsors and Enablers Process & Role Changes System Capabilities Benefits Clinical & Corporate Priorities Resource Required: ENABLER/ OWNER Resource Required: SPONSOR Whose effort is required to ensure the benefits are achieved? Who are the benefits important to? Whose effort is required to ensure the benefits are achieved? Who are the benefits important to? Benefits Appraisal Process Mapping Next Steps

5. Benefits Appraisal & Process Mapping 5 Benefit Enablers and Owners: Who needs to ensure that each benefit is achieved? Whose working patterns will change if all benefits are realised? What system capabilities enable these changes? Whose working patterns will change if all benefits are realised? What system capabilities enable these changes? Benefits Appraisal Process Mapping Next Steps

6. Benefits Appraisal & Process Mapping 6 Benefit Owners: Who will need to mobilise change in their departments? Who is responsible for ensuring that each change is translated to the operational line? Who needs to lead the enablers of benefits? Who is responsible for ensuring that each change is translated to the operational line? Who needs to lead the enablers of benefits? Benefits Appraisal Process Mapping Next Steps

7. Benefits Appraisal & Process Mapping 7 Benefit Enablers: Whose effort is required to ensure that each benefit is achieved? Process and Role ChangesEnabler(s) Enter Process and Role Change Enter the people whose jobs will change if the system capabilities are used to their full potential. Benefits Appraisal Process Mapping Next Steps

8. Benefits Appraisal & Process Mapping 8 Benefit Sponsors: Who are the benefits important to? Who is responsible for ensuring that each clinical and corporate target is achieved? Benefits Appraisal Process Mapping Next Steps

9. Benefits Appraisal & Process Mapping 9 Benefit Sponsors: Who are the benefits important to? Clinical/Corporate PrioritySponsor Enter Clinical/Corporate Priority Enter the person who is responsible for ensuring that the target or priority is approved. Benefits Appraisal Process Mapping Next Steps

10. Benefits Appraisal & Process Mapping 10 Evaluating Outcomes: Reviewing benefits identified in the previous session Process & Role Changes System Capabilities Benefits Clinical & Corporate Priorities Benefits Appraisal Process Mapping Next Steps

11. Benefits Appraisal & Process Mapping 11 Identified Benefits CIRTMMIBenefit ✓✓✓ Enter Benefit Name RTM: Real Time Management of the Patient Journey CI: Clinical Information MI: Management Information Benefits Appraisal Process Mapping Next Steps

12. Benefits Appraisal & Process Mapping 12 Identified Benefits Are there any benefits to add or remove? Do the benefits listed reflect the clinical/corporate priorities and the reasons why the project has been undertaken? Are there any benefits to add or remove? Do the benefits listed reflect the clinical/corporate priorities and the reasons why the project has been undertaken? Benefits Appraisal Process Mapping Next Steps

13. Benefits Appraisal & Process Mapping 13 Appraisal of Benefits Priority: Some benefits are critical to patient care and the running of the department, while others will be useful, but not as crucial to improving key areas of care. Likelihood: Some benefits will be achieved simply by turning on the system, but some will have numerous dependencies or require intensive training to be realised. ACTION: Stick the benefits to appropriate section of the priority vs. likelihood matrix: For the benefits that have been identified, how likely are they to be realised? How important are they and to whom? Priority: Some benefits are critical to patient care and the running of the department, while others will be useful, but not as crucial to improving key areas of care. Likelihood: Some benefits will be achieved simply by turning on the system, but some will have numerous dependencies or require intensive training to be realised. ACTION: Stick the benefits to appropriate section of the priority vs. likelihood matrix: For the benefits that have been identified, how likely are they to be realised? How important are they and to whom? Benefits Appraisal Process Mapping Next Steps

14. Benefits Appraisal & Process Mapping Appraisal of Benefits Low Priority, Low Likelihood Low Priority, High Likelihood High Priority, High Likelihood High Priority, Low Likelihood Priority Likelihood Benefits Appraisal Process Mapping Next Steps FLAGSHIP QUICK WINS LOW RISK HIGH RISK

15. Benefits Appraisal & Process Mapping Why are the benefits important? Benefits enable 6 aspects of process quality to deliver continually improved services: Adapted from ‘Aims of Improvement’ Institute of Medicine, 2001 Benefits Appraisal Process Mapping Next Steps eHealth Reliable Appropriate Safe Effective Timely Efficient Equitable Patient Centered

16. Benefits Appraisal & Process Mapping eHealth enabled aspects of process quality Benefits Appraisal Process Mapping Next Steps Avoiding injuries to patients from the care that is intended to help them. Safe Improved clinical decision making. Supporting use of multidisciplinary care guidelines. Enabling/ supporting clinical audit. Effective Avoiding waste, including waste of equipment, supplies, ideas, and energy. This includes duplication of information. Efficient Reducing waits and sometimes harmful delays for both those who receive and those who give care. Timely Providing care that is respectful of, and responsive to individual patient preferences, needs, and values. Patient Centred Patient Centred Providing care that does not vary in quality because of personal characteristics e.g gender, ethnicity, geographic location, socioeconomic status. Equitable Reduction in drug errors Electronic dispensing Reduction in drug errors Electronic dispensing Provision of protocol driven pathways, that can be accessed electronically by all members of the multidisciplinary team Shared appointment and scheduling systems Linkage between systems reducing duplication of demographic and clinical information Shared appointment and scheduling systems Linkage between systems reducing duplication of demographic and clinical information System will enable/support electronic immediate discharge summaries to be transmitted from hospital to GP Reduction in cancelled appointments/ operations Will enable transfer of information from one healthcare professional to another, seamlessly crossing the interface between primary, secondary and tertiary care Description Example

17. Benefits Appraisal & Process Mapping Appraisal of Benefits ACTION: For each benefit, and in particular those that are high priority on the priority vs. likelihood matrix, determine which of the quality dimensions they enable: For the benefits that have been identified, how do they improve the delivery of services within NHSScotland? ACTION: For each benefit, and in particular those that are high priority on the priority vs. likelihood matrix, determine which of the quality dimensions they enable: For the benefits that have been identified, how do they improve the delivery of services within NHSScotland? Benefits Appraisal Process Mapping Next Steps

18. Benefits Appraisal & Process Mapping Quality DimensionCount Safe Effective Timely Efficient Patient-Centred Equitable Appraisal of Benefits: Opportunities to Improve Process Quality Priority Likelihood Quality DimensionCount Safe Effective Timely Efficient Patient-Centred Equitable Quality DimensionCount Safe Effective Timely Efficient Patient-Centred Equitable Quality DimensionCount Safe Effective Timely Efficient Patient-Centred Equitable Benefits Appraisal Process Mapping Next Steps

19. Benefits Appraisal & Process Mapping What kind of impact does the system have on the delivery of services? Which improvements are jeopardised if the benefits are not realised? What kind of impact does the system have on the delivery of services? Which improvements are jeopardised if the benefits are not realised? Appraisal of Benefits: Opportunities to Improve Process Quality Benefits Appraisal Process Mapping Next Steps

20. Benefits Appraisal & Process Mapping Summary of Prioritisation Exercise In this exercise, you have determined: –the high risk benefits; –whose effort is required to realise them; and, –the kind of process improvements the benefits require. Benefits Appraisal Process Mapping Next Steps

21. Benefits Appraisal & Process Mapping Process Mapping Benefits Appraisal Process Mapping Next Steps

22. Benefits Appraisal & Process Mapping Process Mapping Benefits Appraisal Process Mapping Next Steps There are guides available from the Improvement and Support Team in relation to process mapping, and this section of the Benefits Management Toolkit should be consider in addition to those. Process mapping is important because it allows any changes to be understood across the whole pathway and therefore minimising negative disruption and maintaining quality of care during transition from current to future state. There are guides available from the Improvement and Support Team in relation to process mapping, and this section of the Benefits Management Toolkit should be consider in addition to those. Process mapping is important because it allows any changes to be understood across the whole pathway and therefore minimising negative disruption and maintaining quality of care during transition from current to future state.

23. Benefits Appraisal & Process Mapping Affected Processes Benefits Appraisal Process Mapping Next Steps For each identified process and role change identified, what are the affected processes or pathways?

24. Benefits Appraisal & Process Mapping Which Processes Does the New System Enable? Process and Role ChangeProcessMapped? Enter name from Benefits MapEnter process or processesYes/No Benefits Appraisal Process Mapping Next Steps

25. Benefits Appraisal & Process Mapping Affected Services For each identified process and role change identified, what are the affected services? Benefits Appraisal Process Mapping Next Steps

26. Benefits Appraisal & Process Mapping Which Services Does the New System Affect? ProcessServices AffectedMapped? Enter process nameEnter services affectedYes/No Benefits Appraisal Process Mapping Next Steps

27. Benefits Appraisal & Process Mapping Complete the Current State Process Maps Is there a current state process map for each of the affected processes? Benefits Appraisal Process Mapping Next Steps

28. Benefits Appraisal & Process Mapping Future State Processes: Reflect changes required to realise benefits Are there any steps that must be shortened or removed? What system capabilities enable this? X X Change to process Benefits Appraisal Process Mapping Next Steps

29. Benefits Appraisal & Process Mapping Affected Roles For each change to a process map, who is affected? Benefits Appraisal Process Mapping Next Steps

30. Benefits Appraisal & Process Mapping Changes to Activities, Processes and Behaviours by Role RoleChanges to Working Practices Enter role (Consultant, Junior Doctor, Charge Nurse, Technician, Porter, etc) Enter changes to working practices (there may be several for each role) Benefits Appraisal Process Mapping Next Steps

31. Benefits Appraisal & Process Mapping 31 Next Steps Benefits Appraisal Process Mapping Next Steps

32. Benefits Appraisal & Process Mapping Approach to Rolling Out Changes The change approach should include all activities needed to: –address the issues identified; –deliver the transformation required; –build capability within the Service/ Board area to sustain the change and deliver future change through training and education; –interventions may be delivered in a number of ways (e.g. dedicated internal team, external consultants, integrated team); –there should be a single co-ordinating body to manage the change together; and, –link interventions to the business case. Typical areas Leading and directing change Building and sustaining capability Communications and engagement Delivering change and enabling benefits Benefits Appraisal Process Mapping Next Steps

33. Benefits Appraisal & Process Mapping Effective Change An effective programme of change requires the following attributes… Absolute clarity of purpose Widely understood & compelling need Clear foundations for success & engaging to deliver Reinforcement of the future Bold, committed leadership Support to deliver Principles to drive sustainable change Measurable outcomes, aligned with strategic imperatives, cascaded responsibility Power aligned with delivery responsibility; efficient governance; effective co- ordination; no competing agenda; resourced to deliver (people and tools) People understand exactly why the change is required and what the organisation will achieve by changing at both the corporate and individual level Readiness to take tough decisions and do what it takes to realise benefits; visible investment in the change, supported by leadership, alignment, tenacity Understanding the history of change; developing the behaviours to succeed; people are actively engaged, compelled by, and involved in making the change happen Locking delivery in to the organisation and rewarding it, managing resistance, building capable managers and sustainable processes Benefits Appraisal Process Mapping Next Steps

34. Benefits Appraisal & Process Mapping Targeted Areas for Change Activities Leading and directing change: –there may be requirements to assess the degree of leadership commitment and extent to which leadership will be able to deliver this project in the organisation; and, –following this, some leadership development activity may be required. Building and sustaining capability: –it is critical to develop skills and capability within the workforce that will enable people; and, –training and development support is likely to be required. Communications and engagement: –communication and engagement are vital to build support for the project; and, –input to develop and deliver communications and to manage stakeholders will be required. Delivering change and enabling benefits: –it is important to make the change happen and then sustain it through effective performance management; and, –expertise in embedding new activities, tools and behaviours into existing performance management system will likely be needed. Benefits Appraisal Process Mapping Next Steps

35. Benefits Appraisal & Process Mapping Change Resources What support will we need to meet our change challenge? What are the high level requirements? Leading and directing changeBuilding and sustaining capability Communications and engagementDelivering change and enabling benefits What support will we need to meet our change challenge? What are the high level requirements? Leading and directing changeBuilding and sustaining capability Communications and engagementDelivering change and enabling benefits Benefits Appraisal Process Mapping Next Steps

36. Benefits Appraisal & Process Mapping Reporting on Success Impact –It is critical to demonstrate impact and success as the project is proceeding. In particular, engaging busy clinicians/managers in the project will be made substantially easier if early success stories can be demonstrated; –eHealth Benefits Management Toolkit 'Benefits Definition & Measurement' demonstrates how qualitative and quantitative measures should be developed and baselines set; –The whole team need to work closely together to measure the impact and identify the success stories; –Refine the change strategy if the measures are not improving; and, –Communicate successes continually. Benefits Appraisal Process Mapping Next Steps

37. Benefits Appraisal & Process Mapping 37 Next Steps –Get sign-off for revised process maps from sponsors, owners and enablers –Target key individuals (enablers and sponsors) and build their involvement and buy-in for upcoming changes. Develop these individuals to become champions. –Plan training and communications to coordinate with roll-out and deployment schedules and identify change leaders and their remits. –Plan for detailed benefits profiling and benefits realisation planning. Benefits Appraisal Process Mapping Next Steps

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