The Patient Journey and Service Blueprint helps visualize the individual journey and patient/care team encounters and interactions that take place along the journey.

Steps to Create Your Own Patient Journey/Blueprint

In the agnostic patient journey/blueprint example, we’ve provided a base that can be readily customized for specific types of healthcare needs and goals. It can also simply provide a jumping off point to visualizing your own journey/blueprint.

Aggregating Your Information

Things to think about when customizing the agnostic version or creating your own:

1. Envisioning the end goal

   1. What is the ultimate in desired activities and outcomes for patients? Caregivers? Care teams?  Other roles?

   2. Is there an interim that needs to happen first (due to feasibility/current limitations) and may factor into the initial blueprint?

   3. Who needs to buy into/support this effort? How do their interests impact the blueprint?
      
      

2. Starting with the end goal(s), start identifying:

   1. Major actors or roles that will be involved in the journey

   2. Primary activities that need to be performed during the journey to reach the desired end goal

   3. Who (actors) will be performing which activities? Are there optional vs required activities? Optional vs required actors for the activities?

   4. What technologies/tools will be used during the performance of each activity by each actor? Keep in mind you’re thinking of an end state so you may need a technology/tool that will need work before it can be implemented/used as desired.

   5. Are there regulations/guidance/decision support that may need to be incorporated in the technologies/tools for them to be used as desired?

   6. Are there any principles you want to guide the process while actors perform their activities?
      
      

3. With the primary activities and the actors identified, you need to think about supporting actors and activities

   1. What roles (actors) will be helpful in making sure the tools/technologies used by the primary actors work in the way they are supposed to work?

Putting the Information in a Useable Format

Once you’ve identified and listed the information for the steps above, it’s time to start pulling the information together in a usable format by selecting a tool that supports iterating your research findings into the structure of the service blueprint template.  The goal is to achieve consensus among stakeholders on the details (exact words) of the service blueprint and communicate that the people, technologies, processes, and policies are identified and appropriately described AND that the gaps in knowledge associated with the people, technologies, processes, and policies are identified and appropriately described. We used Microsoft Excel to iterate on the exact words because we can use the rows and columns to review relationships within the content. For example, we want to show the relationships of the phases of the patient journey with front stage/back stage/back back stage components while reviewing the exact words.

1. We’ve provided a spreadsheet that can be used to aggregate or pull apart different parts of the journey/blueprint and document them

2. The most important thing is to have a good idea of the activities that will take place (optional and/or required) so that information can be grouped accordingly

3. You may not have all the information to begin with and that’s okay. Having a draft will generate ideas and information to add to the spreadsheet.

4. Try to be more detailed and less abstract when it comes to the top layer of the spreadsheet (front stage). It may be necessary to be more abstract than detailed the further you get from the front stage (i.e., support processes) as you gather information.

5. Put this spreadsheet in front of as many knowledgeable people as you can in order to get feedback and drive out details of what is known and what is unknown.

Visualizing Your Information

The visualizations of the Patient Journey and Service Blueprint are artifacts created from Human Factors and User Experience research.  Once you have a spreadsheet with detailed information, think about how you want to present that information and how you hope to use that presentation.  To get feedback on the blueprint?  Strictly as a presentation tool? As the base for more blueprints?  Your expected use(s) of the presentation may impact the tool you choose to create it.

1. PowerPoint

   1. The benefits of PowerPoint are that it is a common tool that is widely used in most office environments and is familiar to most. There will be little time spent in learning the tool. 

   2. A drawback to PowerPoint may be that it is difficult to gather feedback from many sources into a single presentation in a readable and usable format.

   3. Also, the size of the “slide” in PowerPoint will naturally limit the amount of information that can be shown at one time and the breaks between slides may not seem natural/logical.
      
      

2. Mural

   1. The benefits of Mural are that it is a powerful tool for presenting information to a large audience of people, easy to learn how to give feedback on, and a great deal of information can be presented while allowing users to zoom into sections for more details. It addresses the limiting factor of the size of the “slide” in PowerPoint by allowing the entire Patient Journey and Service Blueprint to fit on one “slide” i.e., on the canvas. Mural users can then zoom in/out and pan in any direction to focus on specific details and can collaborate with multiple people contributing simultaneously.

   2. A drawback to Mural is that it is not a tool commonly used and may require learning the tool to get up to speed on how to best use it. It also may require a fee depending on how the organization chooses to use the product.

   3. Creators in Mural also need to spend time thinking about the design of the blueprint such that it is appealing and usable to a large audience, which will require some expertise in design.

How Visualization Artifacts are Being Used by the VA; collaborate with us

The Patient Journey and Service Blueprint visualization artifacts are used to align stakeholder understanding of what is needed to deliver the goal patient experience. These draft templates were created through a collaboration between VA's Human Factors Engineering team and ACTS. For this joint, the goal patient experience is: Patients, Care Teams, and populations experience coordinated, efficient care that achieves health goals supported by computable, interoperable, current, evidence-based information available when, where, and how needed.

The VA Human Factors Engineering team is exploring ways to use this Service Blueprint to support VA Quality Improvement initiatives. This journey/blueprint template is also a centerpiece of the ACTS initiative. 

The Ask: Collaborate with us to achieve the “Art of the Possible” Care Delivery Future Vision.

We are sharing our knowledge and these templates with others so your teams might use these templates and we can all work in a coordinated way to build an eco-system to support the delivery of a transformed healthcare experience. This is a WE project, not a ME project. We want everyone to have the opportunity to benefit and contribute; all feedback and questions are welcome, but we especially want to know how this aligns with:

• your understanding and expectations about optimal patient journeys and what it takes to achieve them (gaps, misalignment, confirmation)
• refining the ACTS HFE contempt demo with an eye towards the having many teams use and get value from it collaboratively

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