Patient Journey Mapping: Case of Lithuanian Health Care System

Abstract

The patient journey (PJ) as a health care quality improvement construct becomes an instrument of management, which aims to increase the effectiveness of health care. Its guiding principle is that the patient experience throughout each stage of interaction with healthcare providers can reveal gaps in service quality and directions for improvement. However, the mapping of PJ raises a number of unresolved issues, such as the issue of discretization of PJ stages, the integrity of PJ in terms of the entire healthcare system, and the unresolved issues of standardization of PJ mapping. The aim of this study is to assess the PJ mapping methodology, adapting it so that the patient's journey reflects the integrity of the entire system, beyond a specific health care institutions frames. Methodology. The study was carried out between July and September 2020. A method of story-telling and semi-structural interview was chosen for patient journey mapping. The study involved doctors from different levels (5 doctors) and patients (5 patients). Reconstructed and generalized PJ has been validated in a selective group in order to screen the critical moments of journey. The study is based on the classical and most popular breakdown of the patient's journey stages: 1) the first symptoms; 2) diagnosis; 3) treatment; 4) rehabilitation; 5) follow out; 6) monitoring and prevention in order to find suitable standardized management elements within the standard stages. Findings and conclusions: The study showed that the patient's journey in Lithuania is characterized by a large number of stops. Furthermore, patients have to go through too many stops at one institutional level until they can proceed further. The PJ is quite clear and transparent in stages of a single health care level but the integration and coordination amongst levels and sectors is limited. Public health/long care nursing/social services as parts of the PJ are separated, the experience of using such services is chaotic. In order to create an integral scheme of the PJ which could be adapted for improving the quality of services on both an institutional level and in terms of the entire healthcare system, it is important to differentiate all possible sublayers of the journey. 3 sublayers of the journey were determined: service dimension, specialization of healthcare institution and patient emotions. It is also necessary to explore the contents of service sublayers, such as prevention, social services, etc. Thus, the stages of the patient journey become multidimensional with multi-actor interface.