Practical Use of Process Mapping to Guide Implementation of a Care Coordination Program for Rural Veterans.

Area of Science:

• Healthcare Management
• Process Improvement
• Veterans Affairs

Background:

• Transitions of care pose high risks for vulnerable populations, particularly rural Veterans.
• Effective care coordination is crucial for mitigating these risks, but best practices for implementation remain unclear.
• Understanding site-specific processes is a common challenge in implementing new care coordination programs.

Purpose of the Study:

• To utilize process mapping as a tool for assessing site context before implementing the rural Transitions Nurse Program (TNP).
• To understand and adapt to the unique transitional care coordination needs of rural Veterans within the VA system.

Main Methods:

• An observational qualitative study guided by Lean Six Sigma principles.
• Data collection involved interviews, direct observations, and group sessions with front-line staff across five VA Medical Centers and nine rural Patient-Aligned Care Teams.
• Ten process maps were created to depict pre-implementation care coordination processes.

Main Results:

• Process maps visually represented the care coordination landscape at each implementation site.
• These maps were instrumental in adapting the TNP intervention, clarifying the specific role of the Transitions Nurse at each location.
• The process mapping activities successfully engaged local staff and facilitated necessary adaptations.

Conclusions:

• Process mapping is a valuable and practical method for assessing complex healthcare systems prior to program implementation.
• This approach enhances understanding of site-specific needs, enabling tailored interventions and improving staff engagement.
• The methodology, combining multiple data sources and Lean Six Sigma principles, shows potential generalizability to other care coordination programs.