With
a career spanning over 30 years in healthcare including front line work as an
Occupational Therapist and more recently within Lead Service Improvement, Mary
Duggan recalls the significance of mind mapping software within her role.
Through her years of experience, Mary adapted her tools and approach in order
to achieve a more productive and intuitive way of working. Recalling a
particular moment in her career, Mary explains just how much mind mapping
software revolutionised her role.
Every mind map tells a story
Thursday, 13 November 2014
Healthcare Service Improvement
Service
improvement is generally seen as a systematic approach that walks people
through the stages of assessment, diagnosis, problem definition and solution
generation. That's how we like to think about it anyway. It is as
comforting as the London Underground map - logical and straightforward to
follow. Many of us will recognise that it also bears as much relationship
to the real world as the London Underground map does. The process is a
useful guide, but at some point you have to involve real people and real-life
complex and messy situations. Then the dissimilarities between the map
and the territory begin to appear.
Many
years ago, I was working in a service for older people with mental health
problems. We were fairly sure that we could be using our resources more
effectively. As part of the initial assessment and diagnostic stage, I
arranged to interview a group of men whose wives all had dementia and were
receiving services from us. I had a well-constructed question set all
ready to go. Within the first minute of the interview, it all started to
fall apart. I asked the first question. One of the men replied
"I'll tell you how it's been..." and began to tell the story of his
experience. I tried to draw him politely back to the question. He
ignored me equally politely and carried on with his story. I bowed to the
inevitable and listened carefully as he and his companions told me what it had
been like to see their wives struggling more and more with everyday life and
their experience of trying to get help. As they ended their stories, I
realised that they had answered all of my questions, naturally and eloquently.
Most importantly, they knew that their stories had been heard.
I
wasn't using mind-mapping back then. I had to spend a considerable length
of time transcribing a tape recording of four men with very broad West
Yorkshire accents. Then I had to try to sort their answers into themes.
I got there eventually.
Just
a few weeks ago, I did some work with a team who were concerned about the
end-to-end time that their referral to admission process took. They
provide a rehabilitation service for people who need longer-term support to
regain their independence. There was a general feeling that the process
was lengthy and cumbersome. The team had
specifically requested support with some lean techniques.
We
had done some initial data exploration which seemed to be telling us that apart
from a few outliers, the process generally took an acceptable length of time.
So what was the problem? They wanted to map the process because
there were aspects of it that they were still not happy about and wanted to
find a way to articulate this.
I
turned up to the next session, armed with huge sheets of paper and packs of
sticky notes. They sat and regarded the blank paper thoughtfully. Then
they began to talk about the process and how they experienced it. The
conversation was free-flowing and divergent. I already had my laptop
connected to a projector, so I suggested that we used a mind-map rather than a
process map. This let them continue with their exploration of the issues
with the added benefit of seeing the mind-map build up as they spoke.
They began to make some very interesting points about the underlying
dynamics of the process of trying to find a good plan of care for individuals
who may be quite chaotic and who certainly don't fit neatly into any
pigeon-holes. This can create significant levels of anxiety among the
people who are trying to support them, and this anxiety easily rubs off onto
processes. The conversation moved away from “how can we speed up the
process” to “how can we take some of the anxieties out of the process”. This required a very different approach from
eliminating waste and work-arounds from a process. It helped the team realise that they needed
to work on helping their stakeholders to understand the process, and that to do
this they needed to use the right language to help people to understand the
part they play in that process.
Working
with mind-maps is a great way to harness free-flowing conversations. In my experience, this is usually the best
place to start. Then, having heard the
underlying story, you are in a good position to select some more structured
diagnostic tools. You will be using your
toolkit with precision and intentionality.
It
isn't difficult to create templates for many of your favourite diagnostic
tools. If you check out the Problem Solving section in the built-in templates
in MindGenius, you will find that there are some there already set up for you
such as 5 whys, cause and effect and key questions.
An
added advantage of using a mind-map as your starting point for service
improvement activities is that even at the earliest stage, you will find people
identifying potential actions. You are
well aware of the dangers of leaping into solution generation before properly
analysing the situation, but there is that natural human impulse to offer
solutions. Mind-mapping lets you have
your cake and eat it. You can create a
dedicated branch in your map for actions.
After exploring the story of the situation and running some diagnostics,
you will be able to see which of those actions are worth pursuing. It's the work of seconds to then drop them
into an action planning map.

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