The Roadmap
The roadmap describes the methodology and structure coaches use to help the weekly Big Room achieve improvements. The roadmap guides coaches and Big Rooms through a logical sequence of steps from assessment through to testing and standardisation in a continual process. Whilst presented as a step-wise process the roadmap offers flexibility dependant on context.
Pre-Phase
The pre-phase is the first and most vital step on the roadmap. Here coaches spend time identifying stakeholders, setting expectations and building relationships before starting the Big Room meetings. Coaches can expect to revisit pre-phase activities throughout the life of the Big Room. Initial pre-phase activities typically take 3-5 months from the beginning of coach training.
Build a Big Room
The 5Vs help to build the Big Room by providing a broad assessment of the pathway. Coaches will start this process and build upon the 5Vs with the Big Room. Whilst the process is started during pre-phase coaches and Big Room participants regularly refer back to them, particularly when considering a new change idea.
Themes
Once the Big Room is confident the 5Vs have provided a comprehensive assessment of the pathway, coaches help the Big Room develop broad themes which describe opportunities for improvement based on the assessment.
Global Aim
From the themes the Big Room develops a global aim which describes the processes where improvements will take place, what they expect the improvement to look like and a statement about why it’s important to work on this.
Generate Change Ideas
When generating change ideas coaches have a range of improvement and thinking tools to help the Big Room develop ideas they can test.
- Change concepts
- Benchmarking & visits
- Process/value stream map
- Fishbone diagrams
- Spaghetti diagrams
- Selection criteria & multivoting
Driver Diagrams
Driver diagrams help the Big Room organise their ideas and aims in a visual and original way. Coaches then use the Model for Improvement to help the Big Room develop specific aims which can be tested through plan, do, study, act cycles. Initially starting with small tests the scale of test increases based on data, evidence and the confidence of the Big Room.
Standardise the Changes
Once improvement is evidenced with a range of quantitative and qualitative data the Big Room may decide to standardise the improvements.
Continuous Process
As a continuous process the roadmap offers opportunities for Big Rooms to reflect, learn and adapt to testing as well as review past improvements. System level data, patient stories and experience are vital to the process.