Bottling knowledge and sharing it - using patient journey mapping to build evidence and improve Aboriginal renal patient care

Abstract

In Australia, rural and remote Aboriginal people with renal disease undergo complex patient journeys. Experienced renal nurses provide patient-centred care, working with patients and their families to identify their priorities and the barriers and enablers to quality care. They coordinate patient journeys, utilising their knowledge of staff and services across the health system. But how is this knowledge and these skills shared with peers and hospital systems? This paper discusses how two senior renal nurses, one in a regional dialysis unit and one in a metropolitan renal ward, joined with peers to form a renal nurse focus group with the aim of improving the coordination and quality of Aboriginal patient journeys and care experiences. Using the opportunities provided through the Managing Two Worlds Together project, they adapted and modified a set of patient journey mapping tools, working with key stakeholders (patients, families, staff) to map individual journeys and critical incidents from multiple perspectives. Each journey was compared to standards of care, and written up as a case study, enabling both the process and findings to be communicated with peers and students. Working as a focus group provided safe spaces for nurses to discuss the current gaps in care, and the mapping tools provided a logical structure for making sense of complexity and identifying appropriate actions for improvement. This collaborative approach to knowledge making enabled these experienced nurses to ‘bottle their knowledge and share it’, as they combined their own tacit clinical knowledge with explicit evidence and external knowledge.