Ambulance Service Blueprint
Research
Facilitation
Service Design
Context
In England, the NHS ambulance service is split into 7 Trusts, each operating a different region of the country.
The ambulance Trusts are responsible for taking care of the patient from the first emergency 999 call until the patient’s condition is either resolved or they are handed over to secondary healthcare professionals. This means while all patient experiences with the Trust start with a 999 call they end either with speaking to a clinician over the phone, the condition being resolved by paramedics, or transferring to medical staff at a local clinic, hospital unit, or A&E.
Brief
The East of England Ambulance Service Trust (EEAST), one of the seven Trusts, enlisted Mima to help them drive innovation into their service model. The initial brief was broad, with the core message being simply to integrate Human Factors into their processes, with a budget given for us to formulate a project plan. At the early stages of scope definition we found that the client’s needs were best met by methods from Service Design and Human Factors together.
My table ideating new solutions together
Activities
To kick off, two of my colleagues and I embarked on ethnographic field studies at the Trust’s three call centres. Experiencing the full 12-hour shifts of the staff members, we learned about their roles, listened in on incoming calls, observed staff fulfilling their duties, and spoke to them at length about their painpoints.
The call centres operate by three main roles: call handlers, dispatchers and clinicians, who are each supported uniquely by management, audit and admin staff. Each have important responsibilities in the care of the patient and efficient organisation of the Trust’s resources, while each also have differing levels of medical expertise.
We also spent 12 hours with ambulance crews, journeying with them to assist patients, observing their workload and interviewing them. We discovered the complexity of the system, with differing roles existing between the ambulance crews as well, as well as a diversity of ambulance types, each holding different equipment and vehicle capabilities. It was insightful to discover how the actions of the call centre operators would pass over to the ambulance crews and vice versa.
The team undertook a structured exercise of compiling our findings and developed them into a service blueprint. It showed the journey of each staff role as well the points at which different computer systems, equipment or external organisations are involved. Initial insights from our service blueprint were presented back to the seniors, gaining buy-in for additional activities.
40 Trust staff members were invited to a 3-day workshop. Ensuring to recruit a representative spread of participants from the different roles and Trust locations, the workshop brought the study findings to the foreground on the first day and built upon them with the staff to co-create an upgraded service blueprint. On the second and third days, our team worked with the staff to develop new solutions and innovations to evolve the Trust into a nation-leading exemplar.
Me noting while listening to a speaker
Outcomes
This project was a favourite of mine because of the enjoyment I could see in the staff that we engaged and the importance this organisation has to the public.
One of our most poignant findings was that every person that works for the Trust does it because they are good people who want to help others. Despite being a very comforting piece of information, this amplified all the staff’s frustrations when systems held them back from delivering the best possible care. The process produced four human-centred, user-inspired innovations that the Trust staff felt would make a perceivable difference to their daily lives and the care they can provide. Handing these over to the Trust at the end of the project was a brilliant accomplishment and a testament to the process we deployed.
Some of the generated ideas beside the blueprints