Delivering Excellence in Health and Social Care: Quality, Excellence, and Performance Measurement

By Max Moullin | Go to book overview

CHAPTER eight
Process improvement

It is no accident that the 'processes' box sits at the centre of the Excellence Model. An organization's processes are central to the experience of service users, patients and carers. It is through these processes that the other enablers are transformed into results.

Everything an organization does can be considered as a process. There is no product or service without a process. Harrington (1991) defines a process as follows: 'Any activity or group of activities that takes an input, adds value to it, and provides an output to an internal or external customer. Processes use an organisation's resources to provide definitive results'.

It is interesting that this definition uses the phrase 'adds value'. That is certainly the intention of a process. In practice, however, many processes may not actually add value. Sometimes a process can deliver negative value - for example, an over-complicated process for staff to apply for a place on a training course may actually deter staff from applying. One of the purposes of analysing processes is to make sure that they do add value; that each step of the process is important. If processes can be simplified, with no adverse effect on the customer, then that is an opportunity for improvement.

Processes can take many different forms. In health and social care they include surgery carried out on a patient, the process for approving someone as a foster carer, developing care plans, responding to requests for information, handling complaints, recruiting and interviewing staff, delivering meals and the process for allocating an individual worker to a specific client.

Coulson-Thomas (1994) distinguishes between three types of process. Business processes are sequences and combinations of activities that deliver value to customers. Management processes control and coordinate these activities and ensure business activities are delivered. Support processes, as the name implies, provide infrastructural and other assistance to business processes.

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