Fillable Service Design Full Set Of Templates (Ireland - Health Service Executive)

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Service Design Full Set Of Templates (Ireland - Health Service Executive)

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Service Design
Full Set of Templates
Template 6.2.3: Description of the Current Situation (Service Operational Model)
Purpose
This template assists you to dene and describe your current Service Operational
Model, to outline the current baseline and to describe the measures that are in place.
It acts as a foundation to guide change activities.
How to use it?
Describe the current situation/baseline of your service in Column 2 based on the
prompts outlined in Column 1. Indicate measures that are in place or agreed in
Column 3.
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Model of Care or Service Provision Model of Care or Service Provision
Overall philosophy of care (medical, psychosocial,
therapeutic, holistic, etc.)
Who will use the service?
Who will deliver the service?
Who will the service interact with most, i.e. referral
sources, other teams or agencies, etc.?
People’s Needs Defining Change Health Services Change Guide
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Eligibility and access criteria
Service delivery arrangements – location, time,
opening hours, etc.
Governance and Leadership Arrangements Governance and Leadership Arrangements
Service team purpose, structure and reporting
relationships
Leadership and decision-making arrangements
(including governing groups and legal or regulatory
requirements)
Clinical governance arrangements:
Supervision practice
Monitoring of professional standards, policies and
procedures
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Business governance including nance, human
resources, etc.
Service level agreements, memorandums of agreements
or other inter-agency agreements
Key activities required to deliver the service: Key activities required to deliver the
service:
Pathways and Processes of Care Pathways and Processes of Care
Referral, assessment, diagnostic, intervention pathway
Shared care arrangements or protocols
Transfer or discharge pathway
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Supporting process, i.e. booking arrangements,
pharmacy systems, notication to other services, etc.
Business Processes Business Processes
Service planning
Policies, procedures, protocols and guidelines (PPPG)
Budget and nancial processes, procurement
arrangements
Costing model for the service (income generation, etc.)
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Information and data management processes
(data bases, etc.)
e-Health and ICT requirements
Communication and information sharing processes
(internal and external)
Administrative support processes and services
Procurement Processes
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Human Resources Human Resources
Workforce planning, talent management succession
planning
Roles and responsibilities
Individual and team performance
Work practices and methods
Work distribution, caseload management
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Learning and development requirements – knowledge,
competencies and skills
Human Resources business processes – time and
attendance, performance systems, etc.
Staff engagement processes
Scheduling, rostering and work ow
Staff health and wellbeing
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Health and safety arrangements
Quality, Patient Safety and Measurement Quality, Patient Safety and Measurement
Quality, standards and measurement processes (including
compliance arrangements, dealing with service feedback/
complaints, etc.)
Indicators – performance measurement (quantitative and
qualitative)
Key performance indicators
Risk management processes
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Current Service Operational Model Baseline of the service – describe the current situation
Your answers in this column will auto-fill into Baseline column in 6.3.3
Measures – outline what is in place
Infrastructure Infrastructure
Utilisation of space/facilities, location of service delivery,
service settings (capital expenditure plans, etc.)
Environmental changes
Equipment (assessment, diagnostic and intervention
requirements)
ICT infrastructure
Resources
Comment on the overall situation with regard to current resources for the service. Identify any anomalies or funding issues that need to be addressed:
People’s Needs Defining Change – Health Services Change Guide
People’s Needs Defining Change Health Services Change Guide
Template 6.2.3: Description of the Current Situation (Service Operational Model) (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Model of care or service provision
Overall philosophy of care (medical, psychosocial,
therapeutic, holistic, etc.)
Who will use the service?
Who will deliver the service?
Who will the service interact with most,
i.e. referral sources, other teams or agencies, etc.?
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model
Purpose
This template enables you to describe the detail of your preferred Service Operational
Model, i.e. how the future service will be organised and delivered. You can also use the
template to focus on an element of your service.
How to use it?
Complete this template for the preferred option
Describe the detail – how the service will be organised and delivered (future vision/
design for the service). Use the prompts to guide you. Complete for all parts of the
service that are changing and/or note if no change is planned.
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Eligibility and access criteria
Service delivery arrangements – location, time, opening
hours, etc.
Governance and leadership arrangements
Service team purpose, structure and reporting
relationships
Leadership and decision-making arrangements (including
governing groups; legal or regulatory requirements)
Clinical governance arrangements:
Supervision practice
Monitoring of professional standards, policies
and procedures
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Business governance including nance, human
resources, etc.
Service level agreements, memorandums of agreements
or other inter-agency agreements
Key activities required to deliver the service:
Pathways and processes of care
Referral, assessment, diagnostic, intervention pathway
Shared care arrangements or protocols
Transfer or discharge pathway
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Supporting process, i.e. booking arrangements,
pharmacy systems, notication to other services, etc.
Business processes
Service planning
Policies, procedures, protocols and guidelines (PPPG)
Budget and nancial processes, procurement
arrangements
Costing model for the service (income generation, etc.)
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Information and data management processes
(data bases, etc.)
e-health and ICT requirements
Communication and information sharing processes
(internal and external)
Administrative support processes and services
Procurement processes
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Human resources (people strategy)
Workforce planning, talent management (skill mix),
succession planning
Roles, responsibilities
Individual and team performance
Work practices and methods
Work distribution, caseload management
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Learning and development requirements – knowledge,
competencies and skills
Human resources business processes – time and
attendance, performance systems, etc.
Staff engagement processes
Scheduling, rostering and work ow
Staff health and wellbeing
Health and safety arrangements
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Quality, patient safety and measurement
Quality, standards and measurement processes
(including compliance arrangements, dealing with
service feedback/complaints, etc.)
Indicators – performance measurement
(quantitative and qualitative)
Key performance indicators
Risk management processes
Infrastructure
Utilisation of space/facilities, location of service delivery,
service settings (capital expenditure plans, etc.)
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Service: Date:
Component of the Service Operational Model Describe the detail of the Service Operational Model, i.e. how the future service is organised
and delivered
Your answers in this column will auto-fill into Future Service Operational Model design column in 6.3.3
Environmental changes
Equipment (assessment, diagnostic and intervention
requirements)
ICT infrastructure
Overall resource requirements
Based on describing how the future service is organised and delivered, how will the resources required to implement these changes be assessed?
Who could assist in providing this costing analysis to deliver on the preferred option?
People’s Needs Defining Change – Health Services Change Guide
People’s Needs Defining Change Health Services Change Guide
Template 6.3.2: Detailed Design of the Service Operational Model (continued)
Template 6.3.3: Service Design – Gap and Impact Analysis
Purpose
This template assists you to identify the gap between your current service and the future
Service Operational Model so that actions can be identied to assist you to get from the
current situation to a better future.
How to use it?
Transfer the data from Template 6.2.3: Description of the Current Situation (baseline
data) into the left-side column (prompts can be deleted once detail is completed).
Transfer the detailed data from Template 6.3.2: Detailed Design of the Service
Operational Model into the right-hand column below (Future Service Operational
Model design).
Identify the gaps and complete the middle column. This column will contain the
actions required to get from the current state to the future design. It will also outline
key actions required to address the impact of the changes and the enabling actions.
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Model of care or service provision Model of care or service provision
Overall philosophy of care (medical, psychosocial,
therapeutic, holistic, etc.)
People’s Needs Defining Change Health Services Change Guide
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Who will use the service?
Who will deliver the service?
Who will the service interact with most, i.e. referral
sources, other teams or agencies, etc.?
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Eligibility and access criteria
Service delivery arrangements – location, time,
opening hours, etc.
Governance and leadership arrangements Governance and leadership arrangements
Service team purpose, structure and reporting relationships
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Leadership and decision-making arrangements (including
governing groups; legal or regulatory requirements)
Clinical governance arrangements:
Supervision practice
Monitoring of professional standards, policies
and procedures
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Business governance including nance, human resources,
etc.
Service level agreements, memorandums of agreements or
other inter-agency agreements
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Key activities required to deliver the service: Key activities required to deliver the service:
Pathways and processes of care Pathways and processes of care
Referral, assessment, diagnostic, intervention pathway
Shared care arrangements or protocols
Transfer or discharge pathway
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Supporting process, i.e. booking arrangements, pharmacy
systems, notication to other services, etc.
Business processes Business processes
Service planning
Policies, procedures, protocols and guidelines (PPPG)
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Budget and nancial processes, procurement
arrangements
Costing model for the service (income generation, etc.)
Information and data management processes (data bases,
etc.)
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
e-Health and ICT requirements
Communication and information sharing processes
(internal and external)
Administrative support processes and services
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Procurement processes
Human resources Human resources
Workforce planning, talent management succession
planning
Roles and responsibilities
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Individual and team performance
Work practices and methods
Work distribution, caseload management
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Learning and development requirements – knowledge,
competencies and skills
Human resources business processes – time and
attendance, performance systems, etc.
Staff engagement processes
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Scheduling, rostering and work ow
Staff health and wellbeing
Health and safety arrangements
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Quality, patient safety and measurement Quality, patient safety and measurement
Quality, standards and measurement processes
(including compliance arrangements, dealing with
service feedback/complaints, etc.)
Indicators – performance measurement
(quantitative and qualitative)
Key performance indicators
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Risk management processes
Infrastructure Infrastructure
Utilisation of space/facilities, location of service delivery,
service settings (capital expenditure plans, etc.)
Environmental changes
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Equipment (assessment, diagnostic and intervention
requirements)
ICT infrastructure
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Service: Date:
Current Service Operational Model (baseline)
Your answers in this column will auto-fill from Baseline column in 6.2.3
Actions based on gap and impact analysis
Based on an assessment of the gap between the ‘current state’
and the ‘future state’, identify the actions needed to deliver on
the future Service Operational Model.
Based on an assessment of the impact of the future design
on individuals, teams and the service, what actions are needed
to address these factors?
Your answers in this column will auto-fill into Actions column in 6.3.4
Future Service Operational Model design
Your answers in this column will auto-fill from Service Operational
Model in 6.3.2
Overall resource requirements to deliver the change
Based on describing how the future service is organised and delivered, how will the overall resources required to implement these changes be determined?
Who could assist in providing this costing analysis?
What action is required to complete a full assessment of the resource requirements to support the Action Plan?
People’s Needs Defining Change – Health Services Change Guide
People’s Needs Defining Change Health Services Change Guide
Template 6.3.3: Service Design – Gap and Impact Analysis (continued)
Template 6.3.4: Action Plan
Purpose
This template is the Action Plan that will guide the change process. It outlines the
outcomes you want to achieve, the actions required to deliver on the outcomes,
resources required, persons responsible and timeframes. It is based on the culmination
of all your work on dening the need for change and designing a better future. In
addition to identifying key actions to get from the current situation to the future, key
enabling and sustaining actions also need to be included.
How to use it?
1. Summarise the key outcomes agreed for the change in Column 1 to anchor
the Action Plan.
2. Transfer the actions agreed in Template 6.3.3: Service Design –
Gap and Impact Analysis into Column 2 and align to the outcomes.
3. Identify the key performance indicators that will be used to track and measure
progress on change actions.
4. Identify dependencies and specify the resources required to implement the change.
5. Identify key people responsible for actions.
6. Identify realistic timeframe for delivery of actions.
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
Include detailed actions
Also actions to address risks, to support enablers of the change
and address any dependencies
People’s Needs Defining Change Health Services Change Guide
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
Service: Date:
Outcome*
Actions
Your answers in this column will auto-fill from Actions column in 6.3.3
Key performance
indicators**
Dependencies and
resources
Person(s)
responsible for
action
Timeframe
People’s Needs Defining Change – Health Services Change Guide
* Outcomes: What is the expected result or benet of the change? Use a specic change term to assist measurement and analysis, i.e. increased efciency …, reduced number of …,
faster delivery of …, increased satisfaction with …, reduced waiting times …, etc. (‘improved’ or ‘better’ are not specic enough).
** Key performance indicators: Measures used to track delivery of the outcomes.
People’s Needs Defining Change Health Services Change Guide
Template 6.3.4: Action Plan (continued)
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Service Design Full Set Of Templates (Ireland - Health Service Executive)

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Completed 16 July 2020

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