Some of these tasks are created by the way services are designed and provided, such as filling in enrolment forms. Others are created by a health condition, such as monitoring blood glucose levels.
Exploring the patient journey
Reviewers should ‘walk-through’ the patient journey, either independently or with patients, or if this is not possible, talk to patients to identify their journey.
There are often challenges and barriers for patients and their families when they are accessing services in your organisation.
These challenges stop people using your service. Looking at the patient journey can help you identify these challenges.
Questions to ask about the stages of a patient’s journey
- What did the patient have to do to prepare to use your service?
- What did the patient have to do to get to your service?
- What did the patient have to do once they arrived at your service?
- What does the patient have to do after they leave your service?
[A woman stands in front of Wellington Regional Hospital with a copy of an appointment letter]
So, you think about the letter that the family has received at home and it tells you where they’re going to be going, where the appointment is, what time the appointment is. And there’s parking information if they’re driving and a map if they’re driving, so you want to basically trace that route. Or if they’re coming by bus, you need to think about where’s the bus going to be dropping them off.
[The woman enters the main entrance of the hospital. We look around the reception area, which includes signage, the main reception desk, and a volunteer help desk.]
So, as an observer, when you’re trying to map the patient journey you want to come in through the main entrance, which is where patients will be coming through, or families will be coming through, and you need to think about all the directional advice that they’ll be getting when they come in here.
So you might be looking for signs, or you might be looking to volunteers who are providing help, or the reception desk which is over here.
So that’s walking in through the main entrance. You also have to think about if they were coming in through one of the other entrances like the entrance from the carpark is over here by the lifts. And at the back of the building there’s another entrance where there’s some other parking that people may have come in from.
[The woman goes up an escalator out of the reception area.]
So you want to literally go on the journey with the patient. And here we’re going to go through the corridors to the outpatient service. And as you go you’re looking for, once again, signs or printed material that tells you where to go.
[The woman stops beside a sign that says Cancer Day Unit, Intensive Care, Link to GNB Yellow Lift, and Women’s Clinics.]
So what we’re doing right now is walking through the hospital to get to children’s outpatients. As yet there haven’t been any signs that say children’s outpatients but in our letter it said that we’re in the Grace Neill Block, which is the GNB Block, and you get there using the yellow lift. So for now we’re following the signs to the yellow lifts.
[The woman stops beside a sign that says GNB (Grace Neill Block).]
So here’s a sign that says we’re actually at the Grace Neill Block so we know what GNB stands for which is great, and a big picture of the yellow lift so we’ve arrived.
[We look at the signage beside the lift.]
So when you get to any lift area you’ll find that there’s a lot of environmental print to look at. And this is the sign for the yellow lifts and it has 2 columns, 13 levels’ worth of information. And there’s information about where you’re at which is we’re here on Level 3 and we’re looking for children’s outpatients. You’ll see there’s a hospy and a children’s hospital here so that might be slightly distracting. But if you come down to Level 5 you’ll see that there is children’s outpatients so that’s where we’re heading.
But this is quite a complex and lengthy sign, particularly if English isn’t your first language that’s a lot of information to be working through to find the information that you need.
[She uses the lift, and goes through the corridor until she arrives at the reception for children’s outpatients.]
And so here we are at children’s outpatients.
[Logos: Ministry of Health and Workbase]
Examples of patient journeys
A patient journey can be presented in a way which demonstrates the health literacy challenges in the journey.
These 3 examples of patient journeys are presented in different ways to highlight health literacy challenges.
Child’s outpatient journey
The Child’s outpatient journey (PDF, 610 KB) demonstrates the large number of health literacy tasks and multiple health services a family is involved with for 1 outpatient visit.
Diabetes patient journey
The Diabetes patient journey (PDF, 1007 KB) demonstrates that managing a long term condition involves a series of daily health literacy tasks for a consumer, supported by occasional visits to a health professional.
Oral health journey
The Oral health journey (PDF, 192 KB) demonstrates how good oral health requires prevention and regular checks over a life-time, but consumers often behave quite differently before starting school, when at school, and as adults.