Service Redesign Resource
Useful Tools, Resources and Information
Note: The links to external websites and resources are provided for information only. Their use does not imply endorsement by the Management Innovation Council. See full disclaimer
Action Research
 Southern Cross University’s action research site
Additional Tools
Gantt charts
A horizontal bar chart that graphically illustrates
a project schedule. It can show start and finish points, elements
of a project, the people involved etc. The chart can be shaded
as tasks are completed.
Gantt Charts - overview
- American
Society for Quality
PDSA cycles
Plan Do Study Act cycles. These allow you to
make changes in small steps, measure the steps to see that they are leading
to an improvement and then make further changes.
Project Planning and Implementing Tools
- American
Society for Quality
Testing Changes
- Institute for Healthcare Improvement
The Improvement Model
- Texas Association of Community Health Centers (TACHC)
Analyse
The UK’s Joint Information Systems Committee (JISC) has a mission to provide world-class leadership in the innovative use of information and communications technology to support education and research. The JISC infokits are excellent resources that have been used throughout this resource page. The infokits contain a range of diagnostic and analysis tools below that may be useful in analysing your current situation. This link goes to their tools and techniques home page:
JISC analytical tools and templates
Analytical tools and templates overview
- JISC infonet UK
The links below go to some of the individual tools:
Assumption surface testing
Encourages challenging assumptions that underpin many of the choices and decisions that can impact on redesign work.
Assumption surface testing overview
- JISC infonet UK
Backward planning
An analytical tool from JISC that helps get people thinking differently about how to get where they want to be.
Backward planning overview
- JISC infonet UK
Benchmarking
This JISC page explains the concept of benchmarking and has links to some useful benchmarking tools.
Benchmarking overview
- JISC infonet UK
Clarimission
Outlines the benefits and characteristics of a change management mission statement. Another useful link from JISC
Clarimission overview
- JISC infonet UK
Clariscope
A decision-making tool that helps clarify a project’s scope
Clariscope overview
- JISC infonet UK
Five whys
A systematic questioning technique that involves
asking “Why” at least five times to get to the real cause
of a problem.
5 Whys overview
- JISC Infonet UK
Lewin’s Force Field Analysis
Assists with an analysis
of the forces that exist in your environment that are promoting a push
for change as opposed to the forces that are working to maintain things
the way they are.
Force Field Analysis overview
- JISC Infonet UK
Force Field Analysis explanation and uses
- 12Manage
PESTLE analysis
Encourages an analysis of factors affecting the
organisation that come from the external environment – usually done prior
to a SWOT analysis.
PESTLE and SWOT Analyses
- JISC Infonet UK
Prioritisation matrix
A tool for setting priorities for change management projects
Prioritisation matrix overview
- JISC infonet UK
Seven Ss
A model for looking at your organisation/unit/dept etc
as a whole and determining the skills and resources that exist within the
unit to allow you to achieve your purpose.
7S Model - an overview of the model
- JISC Infonet - UK
7-S Framework description, history and meaning
- 12Manage
SWOT analysis
Facilitates thinking about an organisation’s
strengths, weaknesses, opportunities and threats.
SWOT analysis - method and examples, with free SWOT template
- Businessballs
SWOT analysis - definition, analyses, profile and limitations
- NetMBA Business Knowledge Center
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Business Cases
These papers describes the Who, What, When, Why and How of writing business cases
What is a business case?
- Prosci Reengineering Learning Centre
How to write and appraise a business case
- British Medical Journal
Business Process Reengineering
This is a customer driven process
redesign approach that tends to involve radical, large scale change with
the aim of achieving dramatic improvements.
Business Process Reengineering (BPR)
- 12Manage - Management Methods and Communities of Interest
Business Process Reengineering method
- Value Based Management
Practical application of Business Process Re-engineering principles in a mental health setting
- BNet
The Better Skills, Best Care Workforce design strategy website has information about workshops and projects that are being run as a part of the strategy to address workforce redesign issues in the Victorian health system. This site also has a range of tools and resources that are useful for workforce and other redesign projects.
Better Skills, Best Care
- Victorian Government Department of Human Services
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Clinical Governance
This paper was developed by the Victorian Quality Council to advise clinicians on their role in clinical governance and to highlight the importance of clinical leadership in implementing safety and quality improvement programs.
Developing the clinical leadership role in clinical governance: A guide for clinicians and health services
Victorian Quality Council
Consumer participation
The Health Issues Centre is a not for profit organisation that promotes consumer perspectives in the Australian Health System
Health Issues Centre
This resource from the Victorian Quality Council lists consumer organisations that are interested in working with health services to improve the quality and safety of health care
Finding consumers and carers: A guide to sourcing consumer, carer and community members for collaborative health service improvement
- Victorian Quality Council
This paper explores the roles of consumers and health care organisations in achieving consumer collaboration in safety and quality improvement
Enabling the consumer role in clinical governance
- Victorian Quality Council
This toolkit is designed to help hospitals and units within hospitals to assess commitment to and capacity for consumer (patient) care and community participation.
Consumer and community participation self-assessment tool for hospitals (PDF file, 307kb)
National resource centre for consumer participation in Health
Developed to assist WA Health and professionals working in the health system to implement meaningful and effective consumer, carer and community engagement strategies. The Health Consumer, Carer and Community Engagement Framework covers engagement at four levels: individual patient interaction; department, program or service level; area health level; and WA Health level. A number of tools aimed at helping services implement the framework are included.
WA Health Consumer, Carer and Community Engagement Framework (PDF file, 394kb)
- WA Health
This kit contains checklists, planning tools, resources, templates and case examples to assist health services plan and implement community participation activities.
Consumer and Community Participation Toolkit (PDF file, 1.22mb)
- Health Issues Centre
Improvement Leaders' Guide - Involving Patients and Carers - General improvement skills (PDF File 1.14B)
- NHS - UK
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Data
Analysing data
Analysing data – This is a short and easy guide to simple quantitative and qualitative data analysis for non-statisticians
Analysing data guide
- Planning and evaluation resource centre
The Victorian Quality Council provides an introduction to the role of data in quality improvement and helps members of health care teams understand the basic concepts and tools required to utilise data for quality improvement activities.
A guide to using data for health care quality improvement.
- Victorian Quality Council
Data collection tools
Data Collection Tools and Methods and Collecting Data
- Planning and Evaluation Resource Centre
Building a Data Collection Plan
- Six Sigma
DeBono’s Six thinking hats
Provides a structured guide to facilitate thinking about a problem from a
range of different ways.
Six Thinking Hats
- Learners Link
Six Thinking Hats
- Mind Tools
Six Thinking Hats
- Sylvie Labelle
The following abstract describes the use of a game involving the six thinking hats to stimulate reflection and critical thinking in a palliative care setting.
Using Edward de Bono's six hats game to aid critical thinking and reflection in palliative care
- International Journal of Palliative Nursing
Define the Process
The NHS's Big Wizard Toolkit contains a set of tools that can be used in process redesign. Tool 1 is a process definition tool.
NHS Modernisation Agency - Demand Management Group
 Improvement
Tools Version 1.2 - 11 September 2002 (DOC file, 410KB)
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Evaluation
Evaluation cycle
Evaluation Cycle
- National resource Centre for Consumer Participation in health
Program Planning and Evaluation Cycle
- Planning and Evaluation Resource Center
Evaluation tools
Center for Education Integrating Science, Mathematics and Computing (CEISMC)
- Georgia Tech's College of Sciences
Program logic
Program Logic - An Introduction
- Audience Dialogue
Improvement leader's guide
Improvement Leaders' Guides: General Improvement Skills
- NHS Institute for Innovation and Improvement
Evidence based decision-making
A resource from Monash University that outlines the principles of adopting an evidence-based approach to organisational change:
Using evidence in decision-making
- Monash University
Examples of improvement outcomes
Improvement outcomes in the Australian health system
Redesigning care - Flinders Medical Centre, South Australia
The Redesigning Care program was initiated at Flinders Medical Centre (FMC) during the winter of 2003. The main aim was to address the increasing demand for emergency services and elective surgery in the hospital.
FMC soon became one of the first hospitals in Australia to use lean thinking to redesign hospital processes across the whole spectrum of clinical care.
The following article reports on a system-wide redesign for unplanned hospital attendances in over 60 hospitals in NSW.
Clinical process redesign for unplanned arrivals in hospitals from the eMJA
- eMJA
Reports on results in redesign of surgery undertaken by the Area Health Services in 96 NSW hospitals.
Applying clinical process redesign methods to planned arrivals in New South Wales hospitals.
- eMJA
Using “lean thinking” has enabled the Flinders Medical Centre to provide safer and more accessible care during a period of growth in demand.
Redesigning care at the Flinders Medical Centre: clinical process redesign
- eMJA
Victorian initiatives
The Redesigning hospital care program in Victoria presents the framework for a four-year statewide initiative that will deliver significant health service improvements through applying process redesign methodologies in Victorian public hospitals.
Redesigning hospital care program in Victoria
- Victorian Government Department of Human Services
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Fishbone diagram
Another visual representation of a problem. It
helps to get teams thinking about the many possible causes of a problem
rather than focusing too quickly on only a limited number of possible causes.
Fish Diagram - Description, When to use and Procedure
- American Society for Quality
Forming Effective Teams
Forming the Team
- Institute for Healthcare Improvement
 Belbin Team Role Summary Table (PDF file, 21KB)
This well-known team roles model was developed by Meredith Belbin and identifies a range of different characteristics of team members
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Improvement leaders guides
Improvement Leaders' Guides: General Improvement Skills
- NHS Institute for Innovation and Improvement
Implementation
JISC
Infonet - Implementing Process Redesign
- JISC Infonet
Improvement measures
Measures - differences between measurement for improvement and measurement for research
- Institute for Healthcare Improvement
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Kaizen
Kaizen is about adopting a continuous, incremental approach
to improving processes rather than one off, dramatic changes.
Kaizen Definitions and Methodology
- 12Manage
Kaizen Overview
- JISC Infonet - UK
L
Lean
Lean Thinking is a process improvement methodology developed
in the manufacturing industry by Toyota. It has now been widely applied
in the health industry. It focuses on reducing waste and improving
process flow. Flinders Medical Centre in South Australia has implemented a wide range of process redesign initiatives using Lean Thinking. Lean methodology has also been used widely in the UK National Health Service.
The Australasian Lean Healthcare Network was formed in 2007. Its managers include some of the leading Lean practitioners in the Australian Healthcare system
Australasian Lean Healthcare Network
The following paper gives examples of Lean thinking applied in healthcare settings
Going Lean in Health care
- Institute for Healthcare Improvement
Lean Thinking - Useful Links
- NHS Networks - UK
What is LEAN?
- Lean Enterprise Institute
Lean Six Sigma
This approach combines the precise, statistical
and measurement elements of Six Sigma with the concepts of improving flow
and reducing waste that underpin the Lean approach.
This paper gives an example of how one hospital used Lean Six Sigma principles to improve the efficiency of their discharge processes.
Creating a Lean Six Sigma hospital discharge process
- Six Sigma Healthcare
This paper explains Lean thinking, Six Sigma and Lean Six Sigma. It explains how Lean Six Sigma can be applied in health care and gives a range of examples of its application in one hospital.
Lean six sigma in healthcare
- National Association for Healthcare Quality
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Mapping
Process Mapping
Process mapping helps enhance understanding and documenting how a process works.
Improvement Leaders’ Guide - Process mapping, analysis and redesign -
General improvement skills (PDF file, 217kb)
- NHS - UK
Process mapping – a guide for health service staff
- Victorian Quality Council
What is Process Mapping?
- Iowa State Universities
Flow charts
Flow charts are tools that can help with process mapping.
Tool 2 of The Big Wizard toolkit is a simple flow charting tool.
Improvement Tools Version 1.2 - 11 September 2002 (DOC file, 410kb)
- HS Modernisation Agency - Demand Management Group
Flow Chart - Description, When to use and Procedure
- American Society for Quality
Value Stream Mapping
At Flinders Medical Centre in South
Australia, as a part of its Redesigning Care project, Value Stream Mapping
has been used to look at current processes and define future, improved
processes.
Redesigning
Care Fact Sheet (PDF file, 96KB)
- Flinders Medical Centre - S.A
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Organisational Development
A long term effort aimed at improving
organisational effectiveness with an emphasis on management of organisational
culture. It is underpinned by behaviour theories such as action research.
Organisational Development - overview
- JISC Infonet - UK
Organisational Development - definition
- Human Synergistics International
Organisational Development - an explanation
- Welsh Local Government Association (WLGA)
Clinical Governance in Primary Care
This article from the British Medical Journal outlines how Organisational Development has been applied to the effective establishment of clinical governance in a primary health care setting.
- BMJ Group
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Pareto charts
The Pareto principle or 80/20 rule states that 80%
of problems usually arise from 20%of causes. In a Pareto chart,
data is arranged so that the 20% of factors causing most of the problems
are revealed. Pareto charts can be used to display numbers, dollars,
time, severity, perceptions among other things.
Pareto Chart - Description, When to use and Procedure
- American Society for Quality
Process Improvement
Handbook for basic process improvement
- Centre for Strategic Leadership Studies
Process Redesign Objectives
Improvement
Tools Version 1.2 - 11 September 2002 (DOC file, 410k)
- HS Modernisation Agency - Demand Management Group's Big Wizard Toolkit. Tools 3 and 4 assist with setting process redesign objectives.
Process review
Process review kit for education
A detailed process review kit developed for the education sector
- JISC Infonet
Project Management tools
Project Management Information kit
- JISC Infonet
VHSMIC project planning kit (pdf, 130k)
- Victorian Health Service Management Council
Presenting data
Run charts
Run Charts - detailed description
- Skymark Corporation
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Qualitative vs quantitative data
Qualitative vs Quantitative Data
A simple guide to the difference between qualitative and quantitative data
- Oswego City School District Regents Exam Prep Center
R
Resistance to change
Understanding resistance to change
Planning Skills - Overcoming Resistance to Change
- Mind Tools
Resistance to Change
- Schuler Solutions Inc
Dealing with resistance to change
This paper by the Victorian Quality Council discusses strategies for overcoming resistance and barriers to change.
Successfully implementing change
- Victorian Quality Council
Change Management Iceberg
- 12Manage
Six Changes Approaches (Kotter)
- 12Manage
Managing Six Sigma Change Resistance
- Six Sigma
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Setting aims
Setting Aims
- Institute for Healthcare Improvement
Six Sigma
Like most process redesign frameworks, Six Sigma follows
a series of steps. In this case they are called: Define, Measure, Analyse,
Improve, Control. Six Sigma uses advanced statistical measures to
minimise errors in processes.
Six Sigma Definition
- Search CIO
Six Sigma
Description and Process
- 12Manage - Management Methods and Communities of Interest
Six Sigma
- JISC Infonet - UK
Six sigma in healthcare
- American Society for Quality
This article describes how the six-sigma approach, originally developed for manufacturing industries, can be applied in health systems.
Six sigma in healthcare – What to do when the low-hanging fruit is gone
- Six Sigma Healthcare
SMART targets
SMART targets are Specific, Measurable, Realistic and Time constrained.
SMART Targets
- JISC Infonet
Stakeholder analysis
This tool assists you with identifying people
who may be able to influence your process redesign activity in positive
or negative ways. Identifying them now could save you time later
through allowing you to predict where resistance might arise.
Stakeholder Analysis
- The Manager's Electronic Resource Centre
Sustaining the gains
Spreading changes
- Institute for Healthcare Improvement
NHS: Introducing sustaining change
A guide developed by
the NHS which helps to assess and increase the likelihood of sustaining
your improvement project gains
- NHS UK
Improvement leader's guide to sustainability and its relationship with spread and adoption
This site contains Seven guides introducing a range of improvement advice. You can view a PDF of the Improvement leader's guide to sustainability and its relationship with spread and adoption.
- NHS UK
The following article reports on the key elements of success in maintaining process improvement gains based on experiences in NSW and SA.
Implementing and sustaining transformational change in health care: lessons learnt about clinical process redesign
- eMJA
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Tree Diagram
A visual representation of a problem that looks like
a tree with many branches. It helps teams to focus on the specific
details of a particular issue rather than viewing it too broadly or generally.
Tree Diagram - Description, When to use and Procedure
- American Society for Quality
U
Understanding personality types
Understanding that there are different personality types helps when putting
teams together. Carl Jung classified all people along three
personality spectrums. These classifications are still used today. If
you’re not sure how to define your own personality, you might like
to try this personality test made available by the California State university.
Jung Typology Test
- Humanmetrics
Personality Inventory
- California State University - Department of Psychology
Just as there are different personalities, different people may also
have different learning styles. It is useful to understand this
when implementing training or introducing new concepts to team members. If
you are not sure about your own learning style you might like to complete
this learning styles questionnaire from the North Carolina State University.
Learning Styles and Strategies
- North Carolina State University
Index of Learning Styles Questionaires
- North Carolina State University
Learning Styles Inventory
- Spring Branch, Independent School District
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What is a process?
- JISC InfoNet UK
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