Anywhere CAMHS and Process Map and Redesign

19. Process Map

  • As a team (including admin staff) process map the steps families go through from when the referral letter arrives at your service to discharge. Write down the time each step takes and the time between steps. Use different coloured post-it notes to indicate redesign ideas
  • Look for bottlenecks, duplicate processes, non-value added steps and batching.

20. Reduce steps and try the new system

One team meeting, Anywhere CAMHS used a roll of lining paper and post-it notes to map their systems prior to allocation. They drew out every step from the receipt of the letter, including who did which task. They discovered that referrals that came in on a Wednesday were attended to the next day but Friday ones waited a week- because the referral meeting was on a Thursday. They changed their system to a daily look at referrals by a rotating pair of clinicians.

21. Communicate with other CAMHS to find out what works

Ask your neighbouring teams how they organise their first appointment system. Note

  • How they manage the resultant demand for interventions
  • What standard letters they use
  • How they involve users in service design.

Anywhere CAMHS decided to get onto the web! They found loads of ideas on:

www.wise.nhs.uk

www.camhs.org.uk

www.nimhe.org.uk

Discuss the process map from the user point of view:

  • Ask the next family you see- what is the most difficult thing about your system from their point of view?
  • When you process map, think explicitly about the user experience- if you were a user, what would you think?
  • What would your users liked to have known before they came?
  • Note which steps in your processes add no or little value to families’ experience
  • As a team, agree what you feel the ideal wait between steps should be and audit regularly
  • Ensure the waits between steps are as equitable as you can make them- families should not have to wait longer for family work than individual, for example.

Anywhere CAMHS decided that, if they were a service user, they would want a choice of venues and times to be seen, including evenings. They started two evening clinics, one in a school and one at their main base. Staff who worked evenings took time off during the day or accumulated it and added to leave dates.

22. User involvement in process mapping

  • Decide which part of your process you want to process map first e.g. ADHD families.
  • Make it fun! Offer food and drink, maybe a voucher.
  • Process map the steps across all partner agencies
  • Identify the bottlenecks, duplicate steps, and parallel processes.

Anywhere CAMHS posted their process map on the wall of the waiting room and asked for comments.