Problems in healthcare are difficult to comprehend due to complexity, involvement of multiple stakeholders in decision making and fragmented structure of delivery systems. Major Problem Structuring Methods (PSMs) have been used to aid problem understanding which, in principle, can provide greater clarity to strategic problems and engage diverse decision makers using transparent representation that capture differing perceptions of problems. In reality, PSMs can be difficult in accurately representing problems, limited in highlighting improvement opportunities due to non-intuitive visual representations and requirements for facilitators and stakeholders to be experts in tools used. This research aims to address this gap by developing a framework, taking into account characteristics of healthcare delivery systems, advantages and limitations of PSMs with an aim of providing accurate and holistic representation of delivery workflow, so as to promote problem understanding in a rapid manner. The framework, termed CARE, first establishes nature of problem and a commonly agreed problem statement along with an understanding of stakeholder involvement and operating regulations. It then sets specific guidelines for data collection, representation, verification and validation from stakeholders and provides methodology for data analysis which allows facilitator insight into possible flaws in workflow. A case study approach is used to test effectiveness of CARE across two different healthcare settings, each involving a different nature of problem. Implementation of CARE leads to improved participation and ownership amongst stakeholders, ease of facilitation during individual or multidisciplinary meetings, intuitive and informative representation of workflow, minimized time and effort for implementation and minimized dependencies on learning new tools and terminologies. A post mortem indicates the positive impact of CARE on services rendered to the patients, leading to an increase in patient satisfaction and workflow efficiencies. The research concludes by noting the contributions and lessons learnt from this research for healthcare practitioners and possible future work.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:575662 |
| Date | January 2012 |
| Creators | Singprasong, Rachanee |
| Contributors | Eldabi, T. |
| Publisher | Brunel University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://bura.brunel.ac.uk/handle/2438/7617 |
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