- Patient journey is long, complex, and there are many touchpoints in the healthcare eco system. And Each touchpoint need to have their Purposes - I am learning that the definition of Purpose is important. - Having sense of purpose means knowing why you are doing what you are doing. - The WHAT you are doing are the quality and creating value. - First need to understand your Purpose. There is inherent difficulties in coming out with ONE common Purpose even in a hospital because - 1. Incomplete medical knowledge - 2. Every MDT stakeholders have their own perspectives, language and philosophy - 3. Variation in delivery services; personality, skills - 4. Noise - there are external factors and demands on workers and systems. - Organisational / high level definition of Value - whether it’s Triple Aim or Value-based - Triple Aim are - contradictory and competing goals. Hard to achieve - Value base — whose definition? Is it just cost saving in disguise? - Each touchpoints have their own value. - Patient have different values needs at different point in their journey - Every patient is different, with different needs.. their definition of what is value to them is different from what provider think. - Defining Value in the boardroom may be separated from actual on the ground reality. - In this long chain of services, in the patient journey map.. each touch point have their own value to offer to patients.. - Value - What is it we are doing as an organisation?Overall value - Which touch point do what for what value? - What is it, the activity i am doing is valuable for patients? - overall OS in the organisation that support these. --- Production systems - there are different types. Job factory, Craft Shop, Batch Jobs . Important to have the OS that support care. OS is made up of 4 parts. The reason why we cannot make healthcare production line because of the stages of knowledge. There are different kind of care. - Repetitive care - because we already know a lot about it Menu Base Care - not very sure yet, offer some choices. Client preference important Exploratory — really don’t know yet. --