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Journey Map — Outpatient Referral to Treatment Plan

A patient referred by her GP to rheumatology, scored from referral to treatment plan: the nine-week wait is computed as the moment of truth at −2 carrying 3 of 6 pain points, the treatment plan is the +2 peak, and the curve averages +0.3 with a 3-point drop from referral into the waiting list. Fictional hospital and figures, not clinical guidance.

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CUSTOMER JOURNEY MAPOutpatient referral to treatment plan — Kestrel Valley HospitalAdult patient referred by her GP to rheumatology with suspected inflammatory arthritisRAPERSONARuth Adeyemi52, primary-school teacherGOALFind out what is wrong and start treatment before the autumn termNEEDSA date she can plan around · One place for letters and results · To be told what happens nextFRUSTRATIONSRepeating her history to every clinician“I don't mind waiting if somebody tells me how long.”MOMENT OF TRUTHWaiting list−2 · Anxious · stage 2 of 6PEAKTreatment plan+2 · Hopeful · stage 6 of 6PAIN POINTS6most at Waiting list (3)AVERAGE EMOTION+0.3starts +1 · ends +2 · 6 of 6 scoredBEFORE THE CLINICDIAGNOSIS & TREATMENT1GP referralWeek 02Waiting listWeeks 1–93Pre-visitWeek 94Clinic visitWeek 105TestsWeeks 10–136Treatment planWeek 14ActionsWhat they doDescribes three months of jointpain and morning stiffnessHas bloods taken at the surgeryWaits for an appointment letterPhones the booking line twiceReceives the appointment letterCompletes a symptomquestionnaireSees the consultantJoints examined and anultrasound requestedBooks the ultrasound separatelyWaits for resultsAgrees a treatment plan with theconsultantJoins a nurse-led educationsessionTouchpointsWhere it happensGP appointmentReferral letterLetterBooking lineLetterPatient portalReceptionConsultantClinic letterImaging departmentPhoneSpecialist nursePharmacyPatient portalThoughtsWhat they think and say“At least someone is taking itseriously.”“Have they lost my referral?”“Finally — a date.”“She explained everythingproperly.”“Nobody has told me whetherthe results are back.”“Now I know what the next sixmonths look like.”EmotionHow it feels+2+10−1−2+1Reassured−2AnxiousMOMENT OF TRUTH+1Relieved+1Reassured−1Worried+2HopefulPEAKPain pointsWhat gets in the wayNO PAIN POINTS3 PAIN POINTSNo acknowledgement that thereferral arrivedBooking-line queue averages28 minutesSymptoms worsen with nointerim advice1 PAIN POINTQuestionnaire repeats questionsthe GP already askedNO PAIN POINTS2 PAIN POINTSImaging booked through aseparate lineResults visible to staff 9 daysbefore she hearsNO PAIN POINTSOpportunitiesWhat we could changeGive the patient a copy of thereferral and the expected waitText acknowledgement withthe estimated waitInterim self-care and flareadvicePre-fill the questionnaire fromthe referralSame-day ultrasound slotwithin the clinicRelease results to the portalwith a plain-language noteShared care plan visible to herGPOwner & metricsWho acts, how we measurePrimary careReferrals with blood resultsattached 64%Patient accessReferral to first appointment 9weeks (local target 3)OutpatientsQuestionnaire completion 58%RheumatologyClinics running to time 72%ImagingUltrasound wait 16 daysSpecialist nursingTreatment started within 6weeks of first visit 81%JOURNEY INSIGHTSMoment of truth: stage 2, “Waiting list”, at −2 (Anxious) — the lowest point on the curve, carrying 3 pain points.Peak: stage 6, “Treatment plan”, at +2 (Hopeful).Pain points per stage: GP referral 0 · Waiting list 3 · Pre-visit 1 · Clinic visit 0 · Tests 2 · Treatment plan 0 — 6 in total, most at “Waiting list” (3).Sharpest drop: “GP referral” → “Waiting list”, −3 points (+1 to −2).Average emotion +0.3 over 6 scored stages; the journey starts at +1 and ends at +2.7 opportunities across 6 stages; every stage with a pain point has at least one opportunity against it.Illustrative example: Kestrel Valley Hospital is fictional; the persona, quotes and figures are invented and are not clinical guidance.

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title "Outpatient referral to treatment plan — Kestrel Valley Hospital"
subtitle "Adult patient referred by her GP to rheumatology with suspected inflammatory arthritis"
note "Illustrative example: Kestrel Valley Hospital is fictional; the persona, quotes and figures are invented and are not clinical guidance."

persona "Ruth Adeyemi"
  role: 52, primary-school teacher
  goal: Find out what is wrong and start treatment before the autumn term
  needs: A date she can plan around | One place for letters and results | To be told what happens next
  frustrations: Repeating her history to every clinician
  quote: "I don't mind waiting if somebody tells me how long."

phase "Before the clinic"
stage "GP referral"
  time: Week 0
  actions: Describes three months of joint pain and morning stiffness | Has bloods taken at the surgery
  touchpoints: GP appointment, Referral letter
  thoughts: "At least someone is taking it seriously."
  emotion: +1 Reassured
  opportunity: Give the patient a copy of the referral and the expected wait
  owner: Primary care
  metric: Referrals with blood results attached 64%

stage "Waiting list"
  time: Weeks 1–9
  actions: Waits for an appointment letter | Phones the booking line twice
  touchpoints: Letter, Booking line
  thoughts: "Have they lost my referral?"
  emotion: -2 Anxious
  pain: No acknowledgement that the referral arrived | Booking-line queue averages 28 minutes | Symptoms worsen with no interim advice
  opportunity: Text acknowledgement with the estimated wait | Interim self-care and flare advice
  owner: Patient access
  metric: Referral to first appointment 9 weeks (local target 3)

stage "Pre-visit"
  time: Week 9
  actions: Receives the appointment letter | Completes a symptom questionnaire
  touchpoints: Letter, Patient portal
  thoughts: "Finally — a date."
  emotion: +1 Relieved
  pain: Questionnaire repeats questions the GP already asked
  opportunity: Pre-fill the questionnaire from the referral
  owner: Outpatients
  metric: Questionnaire completion 58%

phase "Diagnosis & treatment"
stage "Clinic visit"
  time: Week 10
  actions: Sees the consultant | Joints examined and an ultrasound requested
  touchpoints: Reception, Consultant, Clinic letter
  thoughts: "She explained everything properly."
  emotion: +1 Reassured
  opportunity: Same-day ultrasound slot within the clinic
  owner: Rheumatology
  metric: Clinics running to time 72%

stage "Tests"
  time: Weeks 10–13
  actions: Books the ultrasound separately | Waits for results
  touchpoints: Imaging department, Phone
  thoughts: "Nobody has told me whether the results are back."
  emotion: -1 Worried
  pain: Imaging booked through a separate line | Results visible to staff 9 days before she hears
  opportunity: Release results to the portal with a plain-language note
  owner: Imaging
  metric: Ultrasound wait 16 days

stage "Treatment plan"
  time: Week 14
  actions: Agrees a treatment plan with the consultant | Joins a nurse-led education session
  touchpoints: Specialist nurse, Pharmacy, Patient portal
  thoughts: "Now I know what the next six months look like."
  emotion: +2 Hopeful
  opportunity: Shared care plan visible to her GP
  owner: Specialist nursing
  metric: Treatment started within 6 weeks of first visit 81%