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Service improvement through patient pathways

Sales, Rachel; Denning, Lynn; Donovan, Lesley


Rachel Sales
Occasional Associate Lecturer - HAS - NAM

Lynn Denning

Lesley Donovan


In response to local educational commissioning the University of the West of England in collaboration with five partner organisations developed a one year inter-professional and inter-disciplinary service improvement project. This project is using a work based learning approach to engage each learner in problem solving to enhance the skills of inquiry as this approach is described as key to enabling the development (Moore, 2007). The project commenced in March 2011 with 46 clinical staff each supported in practice by their managers, a workplace facilitator (mentor), and through attendance at action learning sets facilitated by a nurse academic. Each action learning set was created around four identified care pathways (COPD, Orthopaedic/Falls, Dementia/Mental Health and Acutely Ill Child) in response to health improvement. The action learning sets allow for staff working within different teams to critically explore similar priorities whilst also attempting to resolve the challenged that Chandler and Fry, (2009) recognise when they suggested that the effective planning and delivery of high quality care can be hindered by care pathways that cross professional and organizational boundaries. The mentors involved in the project we also supported through mentorship and coaching workshops to support the development and recognition of the role(s) of a work place mentor when supporting a service improvement project.

The key objectives of the project were to

• Identify what the practitioners perceive their development needs were in order to engage effectively in service improvement.
• Establish a clear strategic focus for service development’s as laid down by the separate organisations
• Identify carers and service users to be involved in the service improvement projects
• Articulate changes that needed to take place to meet the strategic objectives
• Identify practice developments needed to implement the change.
• Develop a project to manage the change implementation and the service improvement identified.
• Offer a comprehensive portfolio of learning experiences to enhance the skills and knowledge of the practitioners engaged in this.

Two further service improvements projects exploring End of Life and Public Health are being developed with the positive progress and reviews of pilot project. Mid project evaluations have highlighted a range of challenges and successes and an emergent theme of cross organisational developments and sharing within each of the pathways. Formal evaluations of the project are planned for the spring of 2012. This innovative project recognises that changes that develop and improve patient care are often driven from an individual level and that such initiative can contribute to improvements in efficiency and the quality of care beyond the boundaries of the individual’s organisation (DH 2010) and is supporting a change in the culture of continuing professional development through facilitation to enable positive changes in practice (Lee, 2011).


Sales, R., Denning, L., & Donovan, L. (2012, September). Service improvement through patient pathways. Paper presented at NET 2012 23rd International Networking for Healthcare Education Conference

Presentation Conference Type Conference Paper (unpublished)
Conference Name NET 2012 23rd International Networking for Healthcare Education Conference
Start Date Sep 4, 2012
End Date Sep 6, 2012
Publication Date Sep 4, 2012
Peer Reviewed Not Peer Reviewed
Keywords service, patient pathways
Publisher URL
Additional Information Title of Conference or Conference Proceedings : NET 2012 23rd International Networking for Healthcare Education Conference