Developing an evaluation framework for clinical redesign programs: lessons learnt

J Health Organ Manag. 2016 Sep 19;30(6):950-70. doi: 10.1108/JHOM-07-2015-0109.

Abstract

Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

Keywords: Balanced scorecard; Business process management; Clinical design; Evaluation; Patient journey.

MeSH terms

  • Australia
  • Benchmarking
  • Continuity of Patient Care / standards
  • Health Services Research / methods*
  • Hospital Administration / standards*
  • Interviews as Topic
  • Learning*
  • Organizational Innovation
  • Patient Discharge / standards
  • Quality Improvement