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)
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome