Applying the BTS coaching structure to support multiprofessional teams to design service chains

Abstract The BTS structure was used for the Smooth service chains coaching to support wellbeing services counties to design multiprofessional service chains and pathways for clients in vulnerable positions. The teams consisting of professionals from different services and of an expert-by-experience attended four workshops and active working periods within 12-15 months. Coaches assisted the teams to use different Lean tools to analyse the current situation (e.g. value stream map), to set SMART goals, to model an ideal service path and plan PDSAs to support designing the process and/or implementing it. Also, the teams were advised to collect data to analyse the achieved change and report their models and evaluation results in a national website that operates as a platform for innovation and co-design. A process evaluation was conducted to analyse how the coaching model was implemented, how the activities triggered change and how external factors influenced functioning of the coaching. The data was collected from two coaching rounds which had a total 18 teams participating. Of these, six development teams (n = 31) and five process owners (n = 9) attended group interviews. Also, an interview of coaches (n = 4) and the design team (n = 3) were conducted. The data also includes feedback surveys of all participants in the studied rounds (n = 97) and reporting sheets for teams’ results. The main benefits the participants experienced concerned being able to model the service chain or pilot a new solution, gaining new skills for development work, learning to use different tools, understanding how to form measurable aims and track changes, and becoming familiar with other stakeholders’ work. The challenges included how the new service chains can be implemented and sustained and how to measure the outcomes after the coaching ended. To conclude, the original functions of the Model for Improvement were present but designing and implementing a new service path within the time was challenging.