第一节 what is Patient journey mapping
第一节 什么是患者旅程映射

Hello everybody , Welcome to our Class for the Frontiers of Nursing Discipline Development . this class we will talk about an important concept : Patient journey mapping .
大家好，欢迎来到我们的护理学科发展前沿班。这堂课我们将讨论一个重要的概念： 患者旅程映射 。

Patient journey mapping is an increasingly popular approach to evaluating the experiences of individuals as they navigate complex and dynamic health services and systems.
患者旅程映射是一种越来越流行的方法，用于评估个人在浏览复杂和动态的医疗服务和系统时的体验。

Projects where patient journey mapping methods are used almost always place individuals at the centre of the research in attempts to both understand and improve the experience of the individual and the systems that they navigate. One specific advantage is the capacity of this type of research to provide nuanced clarity about peoples' experiences as they traverse health systems rather than only capturing single episodes of care.
使用患者旅程映射方法的项目几乎总是将个人置于研究的中心，试图了解和改善个人的体验以及他们所驾驭的系统。一个具体的优势是，这种类型的研究能够提供细致入微的清晰度，了解人们在穿越卫生系统时的经历，而不仅仅是捕捉单次护理事件。

The terminology used to describe patient journey mapping projects varies, and includes; process mapping , patient journey modelling , journey mapping , and client journey mapping.
用于描述患者旅程映射项目的术语各不相同，包括：流程图、患者旅程建模、旅程图和客户旅程图。

Several definitions for patient journey mapping approaches to research have been provided in the literature. Barton et al.describe it as “a map of the steps a client takes as he or she progress (sic) through different stages of a disease, often capturing diagnosis and management and interactions with health professionals”. Curry et al. define this process as “a patient-centric activity that details a patient's progress through a healthcare system for a given service”.
文献中提供了患者旅程映射研究方法的几个定义。Barton 等人将其描述为“客户在疾病不同阶段进展（原文如此）时所采取的步骤的地图，通常记录诊断和管理以及与卫生专业人员的互动”。Curry 等人将这一过程定义为“一种以患者为中心的活动，详细说明患者在给定服务中通过医疗保健系统的进展”。

Now ,we can see, patient journey mapping can be viewed as a patient-oriented project that has been undertaken to better understand barriers, facilitators, experiences, interactions with services and/or outcomes for individuals and/or their carers and family members as they enter, navigate, experience and exit one or more services in a health system by documenting elements of the journey to produce a visual or descriptive map.
现在，我们可以看到 ，患者旅程映射可以 被视为一个以患者为导向的项目，旨在更好地了解个人和/或其护理人员和家庭成员在进入、导航、体验和退出卫生系统中的一项或多项服务时的障碍、促进因素、经验、与服务和/或结果的互动，通过记录旅程的元素以生成可视化或描述性地图。

Patient journey mapping projects have been undertaken using a variety of data collection and analytical approaches that have included physically tracking patients' movements through health services , interviewing or surveying patients, family members and healthcare workers about experiences of navigating a health system or health services, auditing case notes , identifying and tracking key touchpoints in the journeys of individuals or groups of people accessing health services or through a combination of methods .
患者旅程绘图项目已使用各种数据收集和分析方法进行，包括通过卫生服务对患者进行物理跟踪，采访或调查患者、家庭成员和医护人员了解在卫生系统或卫生服务中导航的经历，审计病例记录，识别和跟踪个人或群体获得卫生服务或通过方法组合。

In some instances, traditional qualitative or quantitative methodologies have been adapted to describe a patient's experience with a linear approach; in others, newly developed mapping tools integrate information from different perspectives and from multiple dimensions .
在某些情况下，传统的定性或定量方法已被改编为使用线性方法描述患者的体验;在另一些国家，新开发的制图工具整合了来自不同角度和多个维度的信息。

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Then ,the second question is Why were patient journey mapping studies undertaken?
那么，第二个问题是为什么要进行患者旅程图研究？

there were eight distinct reasons for using a patient journey mapping approach.
使用患者旅程映射方法有八个不同的原因。

1.Inform health service redesign/improvement
1. 告知卫生服务重新设计/改进

One of the earliest and most prevalent reasons for adopting a patient journey mapping methodology was to inform the redesign and improvement of health service delivery. Such as“Bringing together findings of patient experience, pathway, and profiles would help all the stakeholders involved to develop better practices for the healthcare process”.
采用患者旅程映射方法的最早和最普遍的原因之一是为卫生服务提供的重新设计和改进提供信息。 例如 “汇集患者体验、途径和概况的调查结果将有助于所有相关利益相关者为医疗保健过程制定更好的实践”。

With services commonly provided by a number of different agencies with varying treatment approaches, the organization of provision including choice of services, allocation of funding and gate-keeping criteria can further influence pathways into services, quality of treatment and completion. Building an understanding of how these factors interact is important to improving the effectiveness of provision.
由于服务通常由许多不同的机构提供，但治疗方法不同，因此提供组织，包括服务选择、资金分配和把关标准，可以进一步影响获得服务的途径、治疗质量和完成。了解这些因素如何相互作用对于提高提供效率非常重要。

2 Develop a deeper understanding of a person's entire journey through the health system(s)
2 更深入地了解一个人在卫生系统的整个旅程

The second most prevalent reason provided for adopting a patient journey mapping approach was to develop a deeper understanding of individuals' and families' experiences of their journeys throughhealth systems (n = 14; 17%). A range of methodological approaches were used to gain a deeper understanding of people's journey through the health system from diagnosis to completion of treatment, with all using qualitative approaches.
采用患者旅程映射方法的第二个最普遍原因是更深入地了解个人和家庭在卫生系统中的旅程经历（n = 14;17%）。使用了一系列方法论方法来更深入地了解人们从诊断到完成治疗的卫生系统历程，所有这些方法都使用定性方法。

3 Identify delays in diagnosis/treatment
3 识别诊断/治疗的延误

Articles in this category used either quantitative or multi-methods approaches to identify specific delays when people were seeking diagnosis or treatment.
这一类别的文章使用定量或多方法来识别人们寻求诊断或治疗时的特定延迟。

Identify gaps in care and unmet needs
确定护理方面的差距和未满足的需求

By focusing on multiple perspectives and illustrating a journey along multiple timelines representing different aspects of a journey, this approach can allow for identification of gaps in healthcare processes that could be mitigated.
通过关注多种观点并沿着代表旅程不同方面的多个时间线说明旅程，这种方法可以识别医疗保健流程中可以缓解的差距。

Transition into and between health services was recognized as important moments in patient journeys . The results of this type of research were viewed as important for improving the provision of services through better understanding and then better meeting people's needs.
进入卫生服务和卫生服务之间的过渡被认为是患者旅程中的重要时刻。此类研究的结果被认为对于通过更好地了解并更好地满足人们的需求来改善服务提供非常重要。

5.Evaluate continuity of care across health services and regions
5. 评估跨卫生服务和地区的护理连续性

Continuity of care within and across healthcare services has long been considered a vital component of patient safety and patient-centred care. This was recognized that adopted a patient journey method to directly evaluate actual and perceived continuity of care.
长期以来，医疗保健服务内部和跨医疗保健服务的连续性一直被认为是患者安全和以患者为中心的护理的重要组成部分。人们认识到，采用患者旅程方法来直接评估护理的实际和感知连续性。

The settings in some studies were undertaken included primary, secondary and tertiary health care settings and a varietyof approaches were adopted to identify enablers and barriers to accessing appropriate and timely care.
一些研究的环境包括初级、二级和三级卫生保健环境，并采用了多种方法来确定获得适当和及时护理的推动因素和障碍。

6.Understand and evaluate the comprehensiveness of care
6. 了解和评估护理的全面性

Some articles adopted and advocated for patient journey mapping approaches to evaluate the comprehensiveness of care, often with patients who had complex needs.Use of multiple methods achieves a more thorough picture of the client journey that includes service data, client perspectives and health logs. The results are potentially very valuable, as there is generally a lack of evidence about the experiences of people receiving multidisciplinary PHD services over time .
一些 文章采用并倡导患者旅程映射方法来评估护理的全面性，通常针对有复杂需求的患者。使用多种方法可以更全面地了解客户旅程，包括服务数据、客户视角和运行状况日志。这些结果可能非常有价值，因为通常缺乏关于人们随着时间的推移接受多学科博士服务的经历的证据 。

7.Understand how people are navigating through health systems
7. 了解人们如何在卫生系统中导航

Some researcher mapped the journeys of patients considered to come from vulnerable populations: transgender individuals , patients with opioid-use disorders , and people who experience psychosis .In their studies, it was recognized that health risks existed, that optimal navigation of health services may be impacted as a result of stigma, and that patient journey mapping offered a way to capture information from this population to facilitate better engagement and enhance healthcare experiences .
一些研究人员绘制了被认为来自弱势群体的患者的历程：跨性别者、阿片类药物使用障碍患者和患有精神病的人。在 IR 研究中，人们认识到存在健康风险，卫生服务的最佳导航可能会因耻辱而受到影响，并且患者旅程地图提供了一种从该人群中获取信息的方法，以促进更好的参与并增强医疗保健体验。

8 Compare patient experiences with practice guidelines and standards of care
8 将患者体验与实践指南和护理标准进行比较

We can adopt a patient journey mapping methodology to compare the experiences of patients with practice guidelines and standards of care . for eg, Alkandari et al. compared the pharmacological treatment prescribed to patients with peripheral neuropathy with treatment guidelines from the UK.
我们可以采用患者旅程映射方法，将患者的经历与实践指南和护理标准进行比较。 例如，Alkandari 等人将周围神经病变患者的药物治疗与英国的治疗指南进行了比较。

Ok ,Dear boys and girls, it is time to have a break.now , ten minutes later ,see you again.
好的，亲爱的男孩和女孩，是时候休息一下了。现在，十分钟后，再见。

we will continue to learn some key questions in patient journey mapping.
我们将继续学习患者旅程映射中的一些关键问题 。