Using Process Mapping to Improve Patient Flow

Delivering health services is tough. Having worked in the NHS for over 14 years, I still struggle to explain how complex it is and how difficult simple things are (like finding a computer that works or, almost impossible, a printer that's connected to a computer). 

There are many approaches to supporting and driving improvement. I think one of the most valuable is simple process mapping, as long as it's clinically led with full input from staff. If you've never heard of it, it's just creating a clear visual map of how work actually gets done (spoiler: how things actually happen is almost always different to how people think it happens).

When we map processes with teams that do the actual work, we always find hidden bottlenecks, rework loops, and opportunities to streamline processes. More importantly, it sparks conversations about the root causes of problems and often highlights issues people didn't even know existed. 

Uncovering the Patient's Journey 

A great example is when I did some work with an NHS acute trust looking to improve patient flow from A&E through to their first inpatient bed. On paper, the processes were sensible, efficient, and broadly followed national best practices. But in reality, what was actually going on was very different. When we spent time where the processes were happening, watching and speaking to people involved in the work, we found that patients had over 20 verbal handoffs between different people before they even left the A&E! The frequent bouts of hidden waiting was a huge part of the delays and staff frustration. This is one of the best parts when process mapping is done properly; it's not all about the physical process but includes all the enabling work and communication, too. 

A Holistic View of the Problem 

With the full process laid bare, communication was one the most significant issues and the issue that was probably easiest to fix from the list we had. Digging into things with the clinical teams, although individual teams and departments were working hard, because they were working in silos with low levels of trust with other departments, patients were getting stuck and they were suffering. Bringing everyone together, helping people understand their colleague's problems, frustrations, and points of view better, finding common ground and a better way of working was actually quite straightforward. 

The Power of Visualisation 

While it may seem simple, visualising work as a process is incredibly powerful. Improving patient flow by reducing non-value-added waiting and handoffs is a win-win for everyone, and should never be underestimated. In this trust, the process mapping helped improve flow, reduced frustration and released some clinical time without any need for complicated systems or additional staff. 

No Transformation Without Co-Design 

I'm not sure any process redesign can be successful without the involvement and buy-in of the staff who deliver the process daily. Whatever you're doing, whether it's process mapping, root cause exploration, or even data analysis, you have to involve those who do the work. 

At Nexus, we have many roles. From bringing in outside perspectives to challenging with knowledge of national best practices or combing through more lines of data than we care to count. But I think our most important role is working with frontline staff, understanding how things actually work, facilitating, asking good questions, and enabling the frontline teams to own their own problems. 

By process mapping and genuinely listening to frontline teams, we can co-create solutions that improve patient outcomes and make jobs easier and less frustrating. That's when sustainable transformation happens—when solutions are designed with people, not just for them. But this doesn't always need consultants or process experts. A poorly done process map is better than no process map, and it's something everyone could have a go at tomorrow if they wanted. 

But if you're struggling or need help figuring out where to start, contact us. We don't just offer consultancy. We also run intensive training programmes, coaching, supporting and training teams to understand, own, and solve their own problems.

If you want a chat, drop us an email at help@nexusconsult.org for chat.