Care by Design understands the fundamentals of organisational development, service management and leadership for the 21st century public sector organisation and communities.
Care by Design understands the fundamentals of organisational development, service management and leadership for the 21st century public sector organisation and communities.
If work is to flow through a process without interruption, we need to organise things so that it flows at the same rate through each part of the process.
And what rate should this be? The rate of the true demand on the service, of course. As you will remember, we have already identified and measured true demand. This is the 'drumbeat' that the patients set for the process (incidentally, the reason why we need to try and reduce variation in demand as much as possible sould now become obvious).
We obviously need to match process capability with this drumbeat. Every part of the process needs to be working to the same beat.
Earlier on we spoke about capacity (as opposed to capability). We need to 'right-size' capacity at each stage in the process in line with the drumbeat. For example, installing a big, fast, "efficient" machine at one particular stage in a process is not an improvement if the other stages in the process are unable to operate at the same speed. The other stages may not even need to operate at this speed in order to maintain the drumbeat. It would quite simply be a waste of money, and would only succeed in creating bottlenecks and queues. Bigger and faster is not necessarily better.
When matching capability with demand, and making the work flow, it is sometimes better to replace a large, fast piece of equipment with a smaller, slower (and less expensive!) one. The smaller, slower one will be more efficient as far as the end-to-end process is concerned.
It would be nice to think that all patients referred for a given service have exactly the same needs and requirements. We know that this is not the case. Different patients will come with slightly different needs.
How can we then maintain our regular drumbeat? Do we design a "one system fits all" process that works (we think) for the majority of patients, and that the other patients will just have to live with?
If the service is going to fully satisfy every patient it will have to be flexible and able to react quickly and efficiently to the differing needs of patients. As part of our service improvement efforts therefore, we will have to predict the level and nature of these differing needs and, from the beginning, build into the process smooth, fast-reacting responses to them so that a drumbeat can be maintained.
To see an example of setting the drumbeat click here.
An example of setting the drumbeat
Published 1st January 1970