The Gantt chart to describe the ideal care pathway
A Gantt chart is a tool typically associated with project management. It is a specific kind of horizontal bar chart which visualizes a project planning. Another common name for the Gantt chart is the time-task matrix. As early as 1991, Karen Zander from the Center for Case Management, Boston, published on the use of Gantt charts to visualize a care pathway.
The basic form of a Gantt chart or time-task matrix is very straightforward. In project management, each row represents a project activity. The columns represent the timeframe for the project. The project manager decides which activities are executed in which period, depicting this in the appropriate rows of the chart. This way, the Gantt chart provides a visual project planning and overview. In this form, a Gantt chart is a valuable tool in the phase 2 of the 7-phase method: project management.
In addition, during the development phase of the 7-phase method, the same format and principles can be used used: the activities (daily care, lab tests, medications, treatments, diet, et cetera) each fill a row. The columns represent the timeframe, see the example below or the example in the 3-blackboard method.
There are several variations possible from this basic form. A first variation can be the ‘time- discipline’ or ‘time-profession’ matrix. In this case, each involved discipline or profession fills a row in the Gantt chart. This can be a helpful tool to determine the overlap in activities by different disciplines. A second variation is the ‘goal-task’ matrix where the timeline is formed not by calendar time, but by goals that have to be met before the patient can proceed in the care pathway.
Other variations in the timeline are possible. Sometimes the day-by-day format is useful, in more longer term care pathways a week-by-week, month-by-month or phased (screening, diagnosis, treatment, rehabilitation, …) format is more suitable. In emergency care, an hour-by-hour format might be useful. Also the location where the care is delivered can be used to represent the timeline, resulting in the ‘location-task’ matrix. Here each column represents a physical location (e.g. emergency department, operating theater, nursing department) in the order in which the care process usually flows.
Not all care pathway are visualized as Gantt charts. For example if the flow of a care processes is not predictable in a timeline, a flowchart or decision tree can be a good alternative to visualize the process.
Zander, K. (1991). Care maps: the core of cost/quality care. New Definition, 6, 1-3.