Case study A journey map helps a health service transform its emergency departments

A journey map helps a health service transform its emergency departments

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Emergency departments are under strain

Australian hospitals received more than 8.8 million emergency department (ED) presentations in 2021/22. This is putting a strain on EDs, many of which are anchored by inefficient systems and processes.

One health service that oversees several EDs asked us to work with it to assess and improve their functioning.

We were asked to help it to understand current performance on operational and clinical governance, and then to identify opportunities to improve.

Our journey map highlights the moments that matter

Emergency departments are large and complicated, so there is no single way to understand performance. Often performance measures within EDs are outside of EDs’ control and should be owned by system-wide progression of care measures.

We started by benchmarking EDs in similar health services and investigating best practice, not just in Australia but around the world. Then we analysed more than 70 documents relating to performance, organisational processes and governance structures.

We knew talking to stakeholders was vital. We wanted to identify the risks of the current approach, understand the culture in the EDs, and explore the EDs’ relationships with wards, senior leaders and community partners.

To gain these insights, we led focus groups with more than 40 clinical and operational staff, surveyed more than 150 staff and interviewed external stakeholders, including the ambulance service and state government officials. These engagements were all conducted with utmost sensitivity.

The research and engagements helped us to design solutions. We developed more than 30 recommendations on everything from workforce to care delivery, cultural and operational safety, leadership and supporting systems.

We also provided the health service with a compelling journey map, highlighting the moments that matter for patients and staff:

Screengrab of patient journey map

(Click here for a larger version of the staff and patient journey map.)

Our recommendations are being put into action

The health service accepted all the recommendations. The health service has established an Emergency Services Improvement Committee to lead the roll-out of innovative improvement work, underpinned by a prioritisation framework we helped design. Patients are starting to enjoy an improved experience when they connect with EDs and staff are collaboratively working towards a safe, calm work environment.

What you can learn from this project

There is great value in exploring what a best-practice journey could look like for patients and health professionals.

Identifying the key moments that matter can help health services to prioritise improvements.

Issues involving emergency departments are complex, and many are unique to each health service.