{"id":7428,"date":"2019-06-18T12:06:00","date_gmt":"2019-06-18T12:06:00","guid":{"rendered":"https:\/\/www.forbetterhealth.co.uk\/?p=7428"},"modified":"2021-02-11T11:48:10","modified_gmt":"2021-02-11T11:48:10","slug":"use-of-a-management-tool-in-improving-patient-care","status":"publish","type":"post","link":"https:\/\/www.forbetterhealth.co.uk\/use-of-a-management-tool-in-improving-patient-care\/","title":{"rendered":"Use of a management tool in improving patient care"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"7428\" class=\"elementor elementor-7428\">\n\t\t\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-fe24a3f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fe24a3f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fe25201\" data-id=\"fe25201\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e588b2f elementor-widget elementor-widget-spacer\" data-id=\"e588b2f\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fe25645 elementor-widget elementor-widget-vc_custom_heading\" data-id=\"fe25645\" data-element_type=\"widget\" data-widget_type=\"vc_custom_heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\" vc_custom_heading no_stripe consulting_heading_font  text_align_left\" ><h1 style=\"font-size: 30px;text-align: left;line-height: 30px;font-weight:700\" class=\"consulting-custom-title\">Use of a management tool in improving patient care<\/h1><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fe258da elementor-widget elementor-widget-stm_post_details\" data-id=\"fe258da\" data-element_type=\"widget\" data-widget_type=\"stm_post_details.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"post_details_wr  consulting_elementor_post_details\">\n    \n<div class=\"stm_post_info\">\n\t<div class=\"stm_post_details clearfix\">\n\t\t<ul class=\"clearfix\">\n\t\t\t<li class=\"post_date\">\n\t\t\t\t<i class=\"fa fa fa-clock-o\"><\/i>\n\t\t\t\tJune 18, 2019\t\t\t<\/li>\n\t\t\t<li class=\"post_by\">Posted by:\t\t\t\t<span>Mouad SBAYLI<\/span>\n\t\t\t<\/li>\n\t\t\t<li class=\"post_cat\">Category:\t\t\t\t<span>Resources<\/span>\n\t\t\t<\/li>\n\t\t<\/ul>\n\t\t<div class=\"comments_num\">\n\t\t\t<a href=\"https:\/\/www.forbetterhealth.co.uk\/use-of-a-management-tool-in-improving-patient-care\/#respond\"><i class=\"fa fa-comment-o\"><\/i>No Comments <\/a>\n\t\t<\/div>\n\t<\/div>\n\t\t\t<div class=\"post_thumbnail\">\n\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1000\" height=\"550\" src=\"https:\/\/www.forbetterhealth.co.uk\/wp-content\/uploads\/2019\/06\/management-tool-1000x550.jpg\" class=\"attachment-consulting-image-1110x550-croped size-consulting-image-1110x550-croped wp-post-image\" alt=\"\" \/>\t\t<\/div>\n\t<\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f30a162 elementor-widget elementor-widget-text-editor\" data-id=\"f30a162\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\n\u201cLean Thinking\u201d implies, using less to do more. This concept of lean thinking has led to the great success of Toyota, which is the world\u2019s largest car manufacturer in terms of overall sales. Thanks to the Toyota manufacturing, lean thinking started to gather shape after Second World War, swiftly developed into principles and philosophy, and had wide spread outside Toyota to reach other organisations in Europe by seventies (1).<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nLean thinking places customers (patient) at the centre of an organisation strive and existence. Its ethos is maximising value to customer (patient) while minimising waste (2).<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nLean thinking is already being applied to various aspects of health care. Although they appear very different, there are remarkably many similarities between manufacturing and healthcare. Whether building a car or providing healthcare to a patient, the people involved must rely on a variety of complex processes to accomplish tasks and provide value to a customer or a patient. By identifying all the steps in these complex processes and removing the steps that do not add value, one can create lean processes.<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nIn essence, the aim of lean thinking is to identify value-added steps in any process, retain them and remove all non-value-added steps, so as to reduce waste. Waste can be of many forms \u2013 money, time, supplies or good will (1).<br \/>\n<\/span><\/p>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c380fb9 elementor-widget elementor-widget-heading\" data-id=\"c380fb9\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">Value Stream Mapping<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b71a0f9 elementor-widget elementor-widget-text-editor\" data-id=\"b71a0f9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nValue stream mapping (VSM) is diagramming and analyzing services (value streams) into their component steps and eliminating any steps (or even entire groups of steps or value streams) that do not deliver value (1).<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nFlow is one of the fundamental concepts of value stream where waste is eliminated and where processes merge into each other, so that there is a smooth flow in the system. The focus is not on waste, but on waste reduction and flow. The concept is applied to the system as a whole, so that, the benefits are optimised (1).<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nThe concept of lean thinking and value stream mapping are very much suited for pull systems (or demand-driven systems), as is healthcare (3). Here, the patient initiates the initial request for a service and that in turn initiates pull in the system. For example, a patient is sent to the surgeon with a problem requiring surgery. This in turn initiates requests for investigations and other consultations (3).<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nThis is in contrast to a push system where, the manufacturer estimates the demand and produces goods. This creates a stockpile in anticipation of customers needs. In healthcare this is the concept on which services are largely, still provided, based on estimates i.e. demand driven or push systems (3).<br \/>\n<\/span><\/p>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-df0b572 elementor-widget elementor-widget-heading\" data-id=\"df0b572\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">Our experience<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5bb5fa6 elementor-widget elementor-widget-text-editor\" data-id=\"5bb5fa6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nIt is currently known more than 85% of surgical cases could be carried out as day surgery. The lists of cases suitable for such practice continuously increases thanks to new added medicines and technologies. Day surgery is becoming a necessity due to pressure on beds, increased health expenses and change in people expectations.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nDay surgery is defined as a surgical procedure undertaken in operating theatres settings under a form of anaesthesia.<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nIt has many advantages. It allows rapid recovery of patient, reduces the risk of hospital-acquired infection and venous thrombosis events to almost zero, reduces bed occupancy; increase work efficiency, while reducing cost.<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nIn view of these advantages and as our Hospital had an ambition to deliver care services to a larger population despite a limited bed capacity that was 205 beds; we carried out a project of development of a day surgery service.<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nDay surgical procedures were in fact undertaken in our Hospital, but were sporadic, patients were not properly informed and prepared, which led to overnight admission and sometimes cancellation. There was also variability of practices among many surgeons and lack of standardization, which crippled operating theatre planning and bed management. Patients overstaying in Hospital in an already limited bed capacity, generated cancellation of surgical cases that caused inconvenience to patients and generated income loss to the Hospital.<br \/>\n<\/span>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b2ac17c elementor-widget elementor-widget-heading\" data-id=\"b2ac17c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">Value Stream mapping in action<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c66a625 elementor-widget elementor-widget-text-editor\" data-id=\"c66a625\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nOver a period of 10 months, we carried out a day surgery service development programme. The first step of project was to organize a value stream mapping of patient\u2019s pathway from the \u2018time of decision to operate\u2019 until discharge from Hospital.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nWe organized a 4-hour session value stream-mapping workshop that included all staff that directly or indirectly have influence patient\u2019s journey. We had 30 staff form different specialties under one roof. These included representation from admission and booking, pre-assessment service, bed managers, operation division, surgeons, anesthetists, pharmacists, information technology, infection control, radiology, operating theatres, wards, operation managers.<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nA Consultant Anaesthetist led on the event with the help of the Medical Director and Quality Managers.<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nOur preparation for the VSM included brainstorming on the list of participants; We then carried out an invitation campaign using different ways communication and negotiation to maximize attendance.<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nOn the day of VSM, we explained how the process mapping would work; we introduced the aims and objectives of the event and stressed importance to put patient in the centre of the whole exercise.<br \/>\n<\/span><br \/>\n<span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nWe created three teams with equal distribution of skills and specialty backgrounds. Each team concentrated on a segment of the patient\u2019s pathway:<br \/>\n<\/span><\/p>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2ca33006 elementor-widget elementor-widget-text-editor\" data-id=\"2ca33006\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">First segment: from \u2018decision to operate\u2019 to \u2018admission to hospital bed\u2019<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Second segment: from \u2018arrival to bed\u2019 to \u2018return from operating theatres\u2019<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Third segment: from \u2018return to bed\u2019 to \u2018discharge home\u2019\n<\/li>\n<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-281acf1 elementor-widget elementor-widget-text-editor\" data-id=\"281acf1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Flipcharts and a variety of markers and colored post-its were used to aid trace the pathway.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">The session was divided into 3 main parts:<\/span><\/p>\n<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">1st part: Current pathway<\/li>\n<\/ul>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Participants mapped the then patient\u2019s pathway. Participants traced every step patient goes through to have surgery. Participants were advised at that stage not criticize the pathway or find better solutions of that journey.<\/span><\/p>\n<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">2nd part: Analysis value<\/li>\n<\/ul>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Participants analysed and critically appraised each step of the pathway by indicating steps that add value to patient\u2019s care and those that are bottlenecks.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">A green colored post-it was added if a step added value. A pink post-it was added if the step was a waste and n orange post-it was chosen if the team did not reach an agreement about the value of the step.<\/span><\/p>\n<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">3rd part: desired pathway<\/li>\n<\/ul>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">At that stage, participants removed waste and linked steps together to form the desired pathway. <\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Figure 1 and 2 illustrate then and desired pathway during the value stream-mapping event.<\/span><\/p>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b650ffd elementor-widget elementor-widget-spacer\" data-id=\"b650ffd\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dba2fb2 elementor-widget elementor-widget-heading\" data-id=\"dba2fb2\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">How did the service look after implementing all changes?<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fbaac59 elementor-widget elementor-widget-text-editor\" data-id=\"fbaac59\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nThe value stream mapping events formulated a new patient\u2019s journey. However, it did not fully answer to what was needed to develop a day surgery service. At the end of the session, a long to-do-list was created.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nThe leading team on the project refined the to-do-list and allocated mini-project to different groups of stakeholders.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nDuring the following 8 months before implementation of day surgery, we created and standardized more than 25 procedures and protocols in order to establish the desired pathway and facilitate day surgery procedures. We also standardized communication means to ensure timely and effective transfer of information to all key cares; we created a new pre-admission procedure that eliminated patient waiting time on the day of surgery. A newly dedicated patient\u2019s information leaflet was produced. We rallied surgeons to agree on lists of surgical cases that were eligible for day surgery setting. We set up performance outcome indicators, which evaluated our intervention and monitored the service performance. A development programme for nurses was set up. Decision-making algorithms based on latest evidence were introduced to empower nurses to take clinically sound decision. It also assisted standardization of clinical practice among surgeons and anaesthetists.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nThe new service was introduced ten months later and following were its main characteristics.<\/p>\n<p><\/span><\/p>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76ba59a elementor-widget elementor-widget-text-editor\" data-id=\"76ba59a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Patient\u2019s education and consenting began at the out-patient clinic soon after decision to operate was taken<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Pre-admission: Pre-operative assessment by an anaesthetist and administrative tasks were carried out before day of surgery<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">A dedicated admission space was created to facilitate patient\u2019s journey and avoid delays on the day of surgery<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Admission and preparation to operating theatres were standardized<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Patient\u2019s passport was introduced and included information about patient\u2019s pathway, to do and not to do checklists, and essential contacts phone numbers.<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Discharge criteria and standardized post-operative pain prescriptions to avoid patient\u2019s discharge delays<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">A new pathway for readmission in case post-operative care complications was introduced<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">The number of day surgery cases markedly increased in piloted specialties. The Urology and Ear-nose and throat cases increased respectively by\u2026. before and after introducing the new set up.\n<\/li>\n<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-021583d elementor-widget elementor-widget-heading\" data-id=\"021583d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">Good things about the value stream-mapping event<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9e3b319 elementor-widget elementor-widget-text-editor\" data-id=\"9e3b319\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div align=\"justify\">\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nHaving people gathered at the same place and time enhances team bonding; align aims and objectives and enthuse people to be engaged. It is amazing how one could learn about how much patient goes trough and how many players influence patient\u2019s journey. It is an education for all participants as they broaden their knowledge on how and why things happen one way or the other.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nEverybody feels empowered to express his or her views and inform on a better change.<\/span><\/p>\n<p><span style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><br \/>\nHaving achieved a desired pathway gave participants great feeling of satisfaction.<\/span><\/p>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eac9eab elementor-widget elementor-widget-heading\" data-id=\"eac9eab\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">Things to be aware of and act on quickly and assertively<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2976eeb elementor-widget elementor-widget-spacer\" data-id=\"2976eeb\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e5da117 elementor-widget elementor-widget-text-editor\" data-id=\"e5da117\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">VSM, as mentioned above is a management tool that is widely used in the industry. Adapting it to patient care is feasible. However, It is important that the \u2018added value\u2019 is well defined and customer that is \u2018patient\u2019 is well identified.<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Participants may need time to engage and get them to talk to each other. Some participants may embank in blame and shame exercise. Others may try to overpower and intimidate others.<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">There is tendency people derail from the process by moving forward and backward of different stages.<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Desired situation is the ideal one, but not always the best one. It is the one an organization could afford to have at that time, within its existing resources and external constraints.<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Such event enthuse people and raise their hopes. It takes time, energy and patience to organize such event. At the end of the day, there is a desired pathway along with a long to-do-list. Therefore, the hard work comes later. People would judge success of the event only when recommendations are implemented.<\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\">Meticulous stakeholder exercise while preparing for the events is vital. It is important to include every key player in patient care to ensure good understanding of the whole process. Omitting some may cost you people engagement and good will.<\/li>\n<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-adbaddc elementor-widget elementor-widget-heading\" data-id=\"adbaddc\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-large\">Conclusion<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bdcb68c elementor-widget elementor-widget-spacer\" data-id=\"bdcb68c\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26c04fa elementor-widget elementor-widget-text-editor\" data-id=\"26c04fa\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p style=\"text-align: justify;\"><span style=\"color: #444444; font-family: calibri;\"><span style=\"font-size: 15px; letter-spacing: -0.4px;\">This programme was an extensive one and included use of management tools, research and audits. It was aimed at improving patient care but also into increasing service delivery. It was also about better planning and predictability while improving service efficiency. It involved many key players including clinicians and managers.<\/span><\/span><\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9b7b98c elementor-widget elementor-widget-spacer\" data-id=\"9b7b98c\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d713eba elementor-widget elementor-widget-text-editor\" data-id=\"d713eba\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><a href=\"http:\/\/www.forbetterhealth.co.uk\/\" target=\"_blank\" rel=\"nofollow noopener\">www.forbetterhealth.co.uk<\/a><\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><a href=\"http:\/\/mailto:serrvices@forbetterhealth.co.uk\/\" target=\"_blank\" rel=\"nofollow noopener\">services@forbetterhealth.co.uk<\/a><\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><a href=\"https:\/\/twitter.com\/fbhmorocco\">https:\/\/twitter.com\/fbhmorocco<\/a><\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><a href=\"https:\/\/www.instagram.com\/fbh.morocco\/\" target=\"_blank\" rel=\"nofollow noopener\">https:\/\/www.instagram.com\/fbh.morocco\/<\/a><\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><a href=\"https:\/\/www.facebook.com\/ForBetterHealthMorocco\">https:\/\/www.facebook.com\/ForBetterHealthMorocco<\/a><\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><span style=\"font-weight: bold; font-family: 'Open Sans', sans-serif;\">Mobile : 07 00 71 99 91<\/span><\/li>\n<li style=\"color: #444444; font-family: calibri; text-align: justify; font-size: 15px; letter-spacing: -0.4px;\"><span style=\"font-weight: bold; font-family: 'Open Sans', sans-serif;\">Fixe\u00a0 \u00a0 \u00a0 : 05 21 21 00 32<\/span><\/li>\n<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-fe26d68 elementor-hidden-tablet elementor-hidden-phone\" data-id=\"fe26d68\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-998afbc elementor-widget elementor-widget-spacer\" data-id=\"998afbc\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fe2714c elementor-widget elementor-widget-stm_sidebar\" data-id=\"fe2714c\" data-element_type=\"widget\" data-widget_type=\"stm_sidebar.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n<div class=\"stm_sidebar consulting_elementor_sidebar\">\n\n            \t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"577\" class=\"elementor elementor-577\">\n\t\t\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-a7c9d69 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a7c9d69\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a7ca28a\" data-id=\"a7ca28a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a7ca66b elementor-widget elementor-widget-wp-widget-nav_menu\" data-id=\"a7ca66b\" data-element_type=\"widget\" data-widget_type=\"wp-widget-nav_menu.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<aside class='widget widget_nav_menu'><div class=\"menu-sidebar-menu-2-container\"><ul id=\"menu-sidebar-menu-2\" class=\"menu\"><li id=\"menu-item-7196\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7196\"><a href=\"\/our-services\/#organisationEng\">Organisation<\/a><\/li>\n<li id=\"menu-item-7197\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7197\"><a href=\"\/our-services\/#parcoursEng\">Patient Pathways<\/a><\/li>\n<li id=\"menu-item-7199\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7199\"><a href=\"\/our-services\/#operationEng\">Operation<\/a><\/li>\n<li id=\"menu-item-7200\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7200\"><a href=\"\/our-services\/#strategieEng\">Strategy<\/a><\/li>\n<li id=\"menu-item-7201\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7201\"><a href=\"\/our-services\/#qualiteEng\">Quality and Certification<\/a><\/li>\n<li id=\"menu-item-7202\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7202\"><a href=\"\/our-services\/#formationEng\">For Better Health Academy<\/a><\/li>\n<li id=\"menu-item-9527\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-9527\"><a href=\"\/our-services\/#investmentEng\">Investment and Partnership<\/a><\/li>\n<li id=\"menu-item-7178\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-7178\"><a href=\"\/our-services\/#coachingEng\">Coaching and Mentoring<\/a><\/li>\n<li id=\"menu-item-9817\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-9817\"><a href=\"\/our-services\/#auditEng\">Audit<\/a><\/li>\n<li id=\"menu-item-9702\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-9702\"><a href=\"\/our-services\/#fbhTechEng\">For Better Health Technology<\/a><\/li>\n<\/ul><\/div><\/aside>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a7caa7c elementor-align-left elementor-widget elementor-widget-button\" data-id=\"a7caa7c\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper icon_align_  button_block\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-lg\" href=\"https:\/\/www.forbetterhealth.co.uk\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">HOME<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-a7cb738 third_bg_color elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a7cb738\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a7cbb6d\" data-id=\"a7cbb6d\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a7cbe85 elementor-widget elementor-widget-vc_custom_heading\" data-id=\"a7cbe85\" data-element_type=\"widget\" data-widget_type=\"vc_custom_heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\" vc_custom_heading  consulting_heading_font  text_align_left title_no_stripe\" ><h4 style=\"font-size: 16px;color: #FFFFFF;text-align: left;font-weight:700\" class=\"consulting-custom-title\">How can we help you?\n<\/h4><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a7cc151 elementor-widget elementor-widget-text-editor\" data-id=\"a7cc151\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"font-size: 13px; line-height: 22px; color: #ffffff;\">Contact us at the For Better Health office or submit a business inquiry online.<\/span><\/p>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a7cc353 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"a7cc353\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper icon_align_left  \">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.forbetterhealth.co.uk\/contacts\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-left\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fa fa-phone-square\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Contacts<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t    \n<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Bring to the table win-win survival strategies to ensure proactive domination.<\/p>\n","protected":false},"author":2,"featured_media":9105,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[112],"tags":[],"_links":{"self":[{"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/posts\/7428"}],"collection":[{"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/comments?post=7428"}],"version-history":[{"count":0,"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/posts\/7428\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/media\/9105"}],"wp:attachment":[{"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/media?parent=7428"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/categories?post=7428"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.forbetterhealth.co.uk\/wp-json\/wp\/v2\/tags?post=7428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}