Clinical Guides: Quality Improvement Guide v2: Understand Current Process

Understanding the current process means mapping out how things currently work in a healthcare setting before making improvements. It involves identifying steps, bottlenecks, inefficiencies, and risks within a process to ensure data-driven, effective changes.

Why is it important?

Understanding the current process:

Prevents assumptions and ensures improvements target real issues instead of perceived ones
Highlights unnecessary steps, delays, and errors
Engages stakeholders
Provides a baseline for measuring change

How to understand the current process in a QI project

Define the process that can be improved
Gather data on the current process
1. Observe, interview, review reports, etc.
Map the process
1. Use a flowchart, swimlane diagram, or value stream map
Identify barriers and root causes
Use findings to inform interventions

Example
In a QI project focused on reducing patient delays when transferring from ICU to general wards, the project lead sought to understand the current process by interviewing staff. These interviews revealed that miscommunication was the primary cause of the delays. To further explore the issue, the project lead created a flowchart to map the current transfer process.

Recommended resources:

Clinical Excellence Commission. (n.d.).Cause and effect diagram.
Clinical Excellence Commission. (n.d.). Flow charts.
NHS. (2014). First steps towards quality improvement. A simple guide to improving services.