Improving the patient treatment pathway

Emma Morriss explores improving the patient treatment pathway

A clear, appropriate and best practice-based patient treatment pathway is crucial. Explore how to review an existing pathway to identify improvements.

At a time of immense change for the NHS, pharma has a role and responsibility in supporting this. As the NHS looks to keep patients out of hospital, reduce waiting lists and the number of times patients attend hospital whether for treatment, testing or drug administration, it’s important to have a clear, appropriate and best practice-based patient treatment pathway or journey.

COVID has empowered patients to take more control of their health and shifted care into the community and at home, wherever possible. This change needs to be reflected in treatment pathways, to understand patients’ healthcare touchpoints, the journey they take and the time it takes at each stage.

What is a patient treatment pathway?
A patient treatment pathway is a best practice journey for the patient to receive appropriate treatment for their health needs. It should be evidence based and draw on expert opinion from all stakeholders, including patients or support group representatives.

For the pharmaceutical industry, mapping the patient treatment pathway gives you the tools to plan your marketing strategy by focusing on those services and patients that are most appropriate and understanding how patients move through their treatment pathway and who they interact with along the way.

For commissioners and healthcare professionals (HCPs), the activity means they can see where a pathway is working, where people may experience delays or drop off and this enables them to address those elements to deliver a quality patient experience.

Not only does an efficient patient treatment pathway benefit the individual, industry and healthcare it also aligns with policy to improve quality and deliver safe, effective, person-centred care in a timely manner.

Mapping the pathway
In order to consider pathway improvements, you need to understand the existing patient journey. To do this, it’s necessary to gather relevant information from the most appropriate stakeholders. During this process you can identify improvements that will lead to creating the ideal pathway.

First, identify your stakeholders. These can range from primary and secondary HCPs, commissioners and budget holders, patients or patient support groups, pharmacists and ancillary staff who interact with patients across the pathway. Getting a good representation of people to input into the pathway map will ensure the journey is considered from all angles.

Engaging all these people can be logistically difficult, but it pays dividends not only in identifying areas of improvement, but also in creating co-working relationships to move to pathway improvement as a collective. An independent facilitator can undertake the administrative elements to bring all relevant parties together as well as run the event to ensure all voices are heard and the process is completed comprehensively and efficiently.

“Once you have a draft patient pathway, consider how many steps there are
and how much time each step takes”

Agreeing the patient treatment pathway
As mentioned, the first step to improve the patient pathway is to identify each stage in the existing journey. You can’t improve what you don’t know.

There shouldn’t be too may stages here and it needs consensus, but consider:

  • Where does the patient start their journey?
  • Does it start with their call to the GP surgery or a referral?
  • What prompts patients to seek help and who do they seek it from?
  • Who interacts with them; receptionist/phone triage?
  • Do they visit the pharmacist for advice?
  • What information or resources can they access?
  • Where do they go following GP contact?
  • Do some patients go straight to A&E and bypass primary care?
  • Once in secondary care, where do they go?
  • What treatment do they receive?
  • Where does the journey end?

You can map the answers graphically or as a flowchart, using directional arrows to show how the patient moves through the stages.

Delve into detail
Once you have a draft patient pathway, consider how many steps there are and how much time each step takes. How long are patients waiting for an appointment or a referral? Is a patient referred multiple times? Is this required? Add these to your map to build up a picture of the typical timescale. Alongside exploring timescales, you also need to examine and note down the tasks involved. These can include:

  • Who undertakes which tasks?
  • Which tasks are necessary, or repeated?
  • The correct order for tasks to avoid errors or repetition.
  • Where common errors lie.
  • Outputs for each stage.
  • Patient experience.
  • Performance against targets.

Review
You now have a typical treatment pathway with input from all stakeholders. You have examined all elements, identified time taken and potential sticking points. You now need to review the diagram to help identify improvements to create the optimal treatment pathway.

Consider whether a patient on the typical pathway is receiving timely and appropriate care. Could they have been diagnosed quicker? Treated quicker? Look at where there may be sticking points, such as:

  • Are some steps taking too long?
  • Are people being referred quickly enough or correctly?
  • Is there a lack of information for patients to seek help?
  • Are they presenting at A&E?
  • Are there gaps in HCP training?
  • Are tasks being repeated?
  • Are the outputs timely and appropriate?
  • Is communication sufficient?

Now categorise these into quick fixes that can be addressed easily and immediately. This might be improving communication, training, streamlining data collection, or combining tasks. Decide who is best placed to make these quick fixes and task them accordingly.

For larger, more system-wide changes, schedule a follow up meeting with the appropriate stakeholders to discuss the next steps to implementation.

By crystallising the current patient treatment pathway, identifying improvements, and implementing them, you will create an efficient treatment pathway, with the backing of all stakeholders, which ultimately improves patient care.

References
[1] How NHS funding and finances are changing patient pathways https://pharmafield.co.uk/opinion/funding-arrangements-finances/
[2] Negotiating the changing NHS landscape: five critical shifts the pharma industry must embrace https://pharmafield.co.uk/spotlight/negotiating-the-changing-nhs-landscape-five-critical-shifts-the-pharma-industry-must-embrace/

For expertly facilitated patient treatment pathway workshops, call E4H on 01462 226126.
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