Abstract
BackgroundJourney mapping involves the creation of visual narrative timelines depicting the multidimensional relationship between a consumer and a service. The use of journey maps in medical research is a novel and innovative approach to understanding patient healthcare encounters.ObjectivesTo determine possible applications of journey mapping in medical research and the clinical setting. Specialist palliative care services were selected as the model to evaluate this paradigm, as there are numerous evidence gaps and inconsistencies in the delivery of care that may be addressed using this tool.MethodsA purposive convenience sample of specialist palliative care providers from the Supportive and Palliative Care unit of a major Australian tertiary health service were invited to evaluate journey maps illustrating the final year of life of inpatient palliative care patients. Sixteen maps were purposively selected from a sample of 104 consecutive patients. This study utilised a qualitative mixed-methods approach, incorporating a modified Delphi technique and thematic analysis in an online questionnaire.ResultsOur thematic and Delphi analyses were congruent, with consensus findings consistent with emerging themes. Journey maps provided a holistic patient-centred perspective of care that characterised healthcare interactions within a longitudinal trajectory. Through these journey maps, participants were able to identify barriers to effective palliative care and opportunities to improve care delivery by observing patterns of patient function and healthcare encounters over multiple settings.ConclusionsThis unique qualitative study noted many promising applications of the journey mapping suitable for extrapolation outside of the palliative care setting as a review and audit tool, or a mechanism for providing proactive patient-centred care. This is particularly significant as machine learning and big data is increasingly applied to healthcare.
Highlights
Patterns of healthcare utilisation are evolving in response to the ageing population and increasing burden of chronic disease
Participants were able to identify barriers to effective palliative care and opportunities to improve care delivery by observing patterns of patient function and healthcare encounters over multiple settings. This unique qualitative study noted many promising applications of the journey mapping suitable for extrapolation outside of the palliative care setting as a review and audit tool, or a mechanism for providing proactive patient-centred care
This is significant as machine learning and big data is increasingly applied to healthcare
Summary
Patterns of healthcare utilisation are evolving in response to the ageing population and increasing burden of chronic disease. A key area of medicine able to address these issues is palliative care. Differing patient, illness trajectory and clinical factors have resulted in inconsistencies in the degree of care provided [4, 5]. This has subsequently translated into significant variability in palliative care research and limitations in applying international evidence to clinical practice [6]. The utilisation of journey mapping has the potential to address these inconsistencies and to our knowledge, this research is the first of its kind. The use of journey maps in medical research is a novel and innovative approach to understanding patient healthcare encounters
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