Navigating Health Services Change: An Overview of the Change Guide ‘Service Design Suite’

The healthcare landscape in Ireland is undergoing a significant transformation, aligning with the ambitious Sláintecare programme and the implementation of health regions. As services are reshaped and delivered in innovative ways, it's crucial to arm healthcare professionals with practical tools that ease these transitions. Adapting to changing delivery models and organisational designs is key, reflecting the need for networked teams and flexible approaches to deliver integrated services. The People's Needs Defining Change - Health Service Change Guide (2018) serves as a vital guide to navigating these changes.

The Design Stage: Crafting a Better Future

In the ever-evolving healthcare environment, the Design stage plays a pivotal role in orchestrating how services are organised and delivered to achieve improved outcomes. The Service Design Suite, embedded within the Health Service Change Guide, provides a structured approach to this critical phase, enabling organisations to test and refine their Service Operational Models.

Here we will delve into the Service Design Suite, a set of four templates aimed at empowering healthcare professionals with structured approaches to service transformation.

Template 6.2.3: Current Service Description

At the heart of the design process is Template 6.2.3, facilitating the description of the Current Service Operational Model. This template serves as a foundational tool, offering insights into current governance structures, leadership arrangements, referral and care pathways, key business processes, and essential infrastructure and ICT resources. Teams employing this template gain a shared understanding of their operational baseline, prompting crucial reflections on the 'why' behind current practices and stimulating discussions on potential improvements. It also creates an opportune moment to engage with service users, incorporating their valuable insights and lived experiences into the redesign process.

Template 6.3.1: Service Design - Option Generation and Appraisal

Embarking on service design/redesign requires a systematic approach, and Template 6.3.1 proves instrumental in this process. By encouraging a comprehensive exploration of various options related to the service operational model, this template acts as a compass for decision-making. It prompts users to consider the current service description and assess the advantages and disadvantages of potential options.

Crucially, the Template guides users in aligning these options with agreed design principles, ensuring consistency with change objectives, and evaluating ease of implementation. The result is a well-informed presentation of a preferred option, ready for consideration by the team and key stakeholders. Whether undertaking a full-scale service redesign or focusing on specific elements, users are reminded to keep an integrated perspective, acknowledging the ripple effects of changes on interconnected services.

Template 6.3.2: Detailed Design of the Service Operational Model

Once the preferred option is identified, Template 6.3.2 steps in to flesh out the details of the chosen Service Operational Model. This Template guides users to describe, in detail, how the service will be organised and delivered. This forward-looking exercise is crucial for envisioning the future state of the service and understanding its impact on both operational and patient outcomes.

The Template's versatility accommodates changes in various parts of the service. Whether the overhaul is comprehensive or targeted, you are guided to use the prompts to articulate the nuanced details of the future service model.

Template 6.3.3: Service Design - Gap and Impact Analysis

Change inherently involves transitioning from the present to a desired future state, and Template 6.3.3 proves indispensable in navigating this transition. By facilitating a comprehensive gap and impact analysis, this template helps identify disparities between the current service and the envisioned Service Operational Model.

By highlighting gaps, teams can strategically plan actions to bridge them, ensuring a smoother transition from the present to a more optimised future. This Template emphasises the need to understand how changes in one part of the service reverberate across the broader system. It encourages a systemic approach, ensuring that the transformation is cohesive and interconnected.

This Template highlights the importance of informed decision-making, acknowledging that effective change is rooted in a thorough understanding of existing challenges and opportunities.

Template 6.3.4: Action Plan - Guiding the Change Process

The Action Plan Template 6.3.4 is the culmination of the collective effort invested in defining the need for change and designing a better future. It outlines clear outcomes, delineates actionable steps, allocates resources, identifies responsible individuals, and establishes realistic timeframes. Crucially, the Action Plan doesn't just focus on immediate actions but emphasises key enabling and sustaining actions, ensuring the longevity and success of the transformative journey.

All these Templates can be accessed on the Health Service Executive website, offering a user-friendly repository for healthcare professionals navigating the complex terrain of change.

Lisa McDaid

January 2024