Thematic Analysis of Data

As a result of the thematic analysis of the participant interviews and focus group data, five key themes emerged: pathway architecture, patient flow, information flow, resource flow and emotional flows. Sub-themes were also identified within some of these themes. The analysis and discussion of the data are presented within the five themes.

Architecture of the COPD Pathway

This qualitative study has tracked COPD patients from pre-diagnosis to post-diagnosis crossing a network ofservices in primary and secondary care. The preliminary results were validated with patients and relatives attending three Breathe Easy groups (groups run by patients for patients and usually supported by the BLF). Four post-take ward rounds were observed on various days and months of the year, including a bank holiday weekend. From analysing the data a high-level process map has been produced which visualises the patient and information flows (see Fig. 7.1) and was used to help identify where lean and agile principles might be applied. The map tracks the patient journey from GP referral through to managing care in the community. Two prominent areas emerged within the pathway which were the pulmonary rehabilitation programme and exacerbations which could result in the patient being hospitalised. From the analysis we propose that at a high level the design of the front-end of the pathway could lend itself to lean principles and the latter parts of the pathway needs to be more responsive to the individual needs of the patients (see Fig. 7.1).

We will further explore the details of the map in the following sections.