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thumbnail of Applying FRAM to support service delivery changes in a re

Author
Nicholas Seaton, Julie Crawford, Vanessa Mclelland, Helen Morris, Amanda Saunders, Rachel Dommett, John Moppett, Laura Pickup
Abstract
This paper describes how Functional Resonance Analysis Method (FRAM) was used to produce a model to support a project team to deliver a planned service change in paediatric leukaemia care. With the anticipated wider use of the immunotherapy Blinatumomab, a regional initiative sought to introduce ambulatory shared care delivery of the medication across an operational delivery network of regional hospitals and family homes. The same team had previously used FRAM to analyse incidents, and the existing model was revisited and expanded to explore new system functions, dependencies, and sources of variability created by the change. By enabling multi professional staff to reason together across organisational boundaries, the model acted as a shared reference for understanding system resilience and guiding practical actions for a risk informed implementation of the proposed service delivery changes. Potential instantiations raised during this process were used to generate a Resilience Analysis Grid questionnaire intended to produce an early profile of the system’s potentials for resilient performance and to help focus attention on areas requiring further support as the pathway is introduced.