Primary care workflow process mapping of medication-related activities performed by non-provider staff: A pilot project's approach

Steckowych, Kathryn; Smith, Marie

doi:10.1016/j.sapharm.2018.09.014

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…Most studies (91%) reported that the map was created to represent current state practice. Four projects [ 82 – 85 ] reported both current state and ideal or future state maps, while 5 describe the ideal or future state process [ 65 , 86 – 89 ]. For example, in TDABC projects the analysis is focused on process costs and is mainly completed after the current state process map is created [ 90 – 95 ].…”

Section: Resultsmentioning

confidence: 99%

Process mapping in healthcare: a systematic review

Antonacci

Lennox

Barlow

et al. 2021

BMC Health Serv Res

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Introduction Process mapping (PM) supports better understanding of complex systems and adaptation of improvement interventions to their local context. However, there is little research on its use in healthcare. This study (i) proposes a conceptual framework outlining quality criteria to guide the effective implementation, evaluation and reporting of PM in healthcare; (ii) reviews published PM cases to identify context and quality of PM application, and the reported benefits of using PM in healthcare. Methods We developed the conceptual framework by reviewing methodological guidance on PM and empirical literature on its use in healthcare improvement interventions. We conducted a systematic review of empirical literature using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Inclusion criteria were: full text empirical study; describing the process through which PM has been applied in a healthcare setting; published in English. Databases searched are: Medline, Embase, HMIC–Health Management Information Consortium, CINAHL-Cumulative Index to Nursing and Allied Health Literature, Scopus. Two independent reviewers extracted and analysed data. Each manuscript underwent line by line coding. The conceptual framework was used to evaluate adherence of empirical studies to the identified PM quality criteria. Context in which PM is used and benefits of using PM were coded using an inductive thematic analysis approach. Results The framework outlines quality criteria for each PM phase: (i) preparation, planning and process identification, (ii) data and information gathering, (iii) process map generation, (iv) analysis, (v) taking it forward. PM is used in a variety of settings and approaches to improvement. None of the reviewed studies (N = 105) met all ten quality criteria; 7% were compliant with 8/10 or 9/10 criteria. 45% of studies reported that PM was generated through multi-professional meetings and 15% reported patient involvement. Studies highlighted the value of PM in navigating the complexity characterising healthcare improvement interventions. Conclusion The full potential of PM is inhibited by variance in reporting and poor adherence to underpinning principles. Greater rigour in the application of the method is required. We encourage the use and further development of the proposed framework to support training, application and reporting of PM. Trial Registration Prospero ID: CRD42017082140

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Section: Resultsmentioning

confidence: 99%

Process mapping in healthcare: a systematic review

Antonacci

Lennox

Barlow

et al. 2021

BMC Health Serv Res

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“…Therefore, for a medication reconciliation program to have a positive impact on the quality of pharmacotherapy, a multidisciplinary approach is essential [ 54 , 65 ]. This re-quires the different healthcare professionals involved in an elderly patient’s care to share responsibility.…”

Section: Discussionmentioning

confidence: 99%

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals

Rojas-Ocaña

García-Navarro

et al. 2022

IJERPH

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The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. Methods. This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient–health professional communication, and the use of Information and Communication Technologies (ICT). Conclusion. The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicine.

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“…Most (91%) reported that the map was created to represent "as-is" practice. Four projects [75][76][77][78] reported both "as-is" and "to-be" maps, while 5 describe the "to-be" process. [79][80][81][82][83] For example, in TDABC projects the analysis is focused on process costs and is mainly completed after the "as-is" process map is created.…”

Section: Phasementioning

confidence: 99%

Process Mapping in Healthcare: A Systematic Review

Antonacci

Lennox

Barlow

et al. 2020

Preprint

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Introduction Process mapping (PM) supports better understanding of complex systems and adaptation of improvement interventions to their local context. However, there is little research on its use in healthcare. This study (i) proposes a conceptual framework outlining quality criteria to guide the effective implementation, evaluation and reporting of PM in healthcare; (ii) reviews published PM cases to identify context and quality of PM application, and the reported benefits of using PM in healthcare.Methods We developed the conceptual framework by reviewing methodological guidance on PM and empirical literature on its use in healthcare improvement interventions. We conducted a systematic review of empirical literature using PRISMA methodology. Inclusion criteria were: full text empirical study; describing the process through which PM has been applied in a healthcare setting; published in English. Databases searched are: Medline, Embase, HMIC–Health Management Information Consortium, CINAHL-Cumulative Index to Nursing and Allied Health Literature, Scopus. Two independent reviewers extracted and analyzed data. Each manuscript underwent line by line coding. The conceptual framework was used to evaluate adherence of empirical studies to the identified PM quality criteria. Context in which PM is used and benefits of using PM were coded using an inductive thematic analysis approach.Results The framework outlines quality criteria for each PM phase: (i) preparation, planning and process identification, (ii) data and information gathering, (iii) process map generation, (iv) analysis, (v) taking it forward.PM is used in a variety of settings and approaches to improvement. None of the reviewed studies (N=105) met all ten quality criteria; 7% were compliant with 8/10 or 9/10 criteria. 45% studies reported that PM was generated through multi-professional meetings and 15% reported patient involvement. Studies highlighted the value of PM in navigating the complexity characterizing healthcare improvement interventions.Conclusion The full potential of PM is inhibited by variance in reporting and poor adherence to underpinning principles. Greater rigour in the application of the method is required. We encourage the use and further development of the proposed framework to support training, application and reporting of PM.Prospero ID : CRD42017082140.

show abstract

Primary care workflow process mapping of medication-related activities performed by non-provider staff: A pilot project's approach

Cited by 11 publications

References 14 publications

Process mapping in healthcare: a systematic review

Process mapping in healthcare: a systematic review

Influence of the COVID-19 Pandemic on Medication Reconciliation in Frail Elderly People at Hospital Discharge: Perception of Healthcare Professionals

Process Mapping in Healthcare: A Systematic Review

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