International Journal for Quality in Health Care Advance Access originally published online on April 10, 2009
International Journal for Quality in Health Care 2009 21(3):214-224; doi:10.1093/intqhc/mzp016
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Health care process modelling: which method when?
Engineering Department, University of Cambridge, Trumpington Street, Cambridge CB21PZ, UK
Objective. The role of process modelling has been widely recognized for effective quality improvement. However, application in health care is somewhat limited since the health care community lacks knowledge about a broad range of methods and their applicability to health care. Therefore, the objectives of this paper are to present a summary description of a limited number of distinct modelling methods and evaluate how health care workers perceive them.
Methods. Various process modelling methods from several different disciplines were reviewed and characterized. Case studies in three different health care scenarios were carried out to model those processes and evaluate how health care workers perceive the usability and utility of the process models.
Results. Eight distinct modelling methods were identified and characterized by what the modelling elements in each explicitly represents. Flowcharts, which had been most extensively used by the participants, were most favoured in terms of their usability and utility. However, some alternative methods, although having been used by a much smaller number of participants, were considered to be helpful, specifically in understanding certain aspects of complex processes, e.g. communication diagrams for understanding interactions, swim lane activity diagrams for roles and responsibilities and state transition diagrams for a patient-centred perspective.
Discussion. We believe that it is important to make the various process modelling methods more easily accessible to health care by providing clear guidelines or computer-based tool support for health care-specific process modelling. These supports can assist health care workers to apply initially unfamiliar, but eventually more effective modelling methods.
Keywords: process diagrams, process modelling, quality improvement, systems understanding
Address reprint requests to: Gyuchan Thomas Jun, Engineering Department, University of Cambridge, Trumpington Street, Cambridge CB21PZ, UK. Tel: 44-(0)1223-332673; Fax: 44-(0)1223-339883; E-mail: gj225{at}cam.ac.uk
Accepted for publication March 20, 2009.