Last 10 Patients Data collection tool

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This tool uses patient information to identify variation in journey times.

What is it?

This tool uses patient information to identify variation in journey times. It helps you understand what is happening in the patient pathway and how this can vary from patient to patient.

Mapping the last ten patients is also useful for comparison with locally agreed care pathways, timescales or key stages in a patient’s journey. It complements both conventional process mapping and value stream mapping.

What does this tool look like?
Last 10 Patients Tool - 4 Sheets from Excel Template Example
Why use this tool?

Mapping the last 10 patients can help understand patient flow within your pathway and identify your longest waits. By looking at a few pathways in detail you are likely to see some improvement ideas that will be applicable to many other patients. For more information see the NHS England how to guide: Layout 1 (

Use this tool when you want to explore the journey that patients are going on through the pathway. It may expose differences in practice or workload, which can cause unhelpful variation, unnecessary delays and compromise safe care.

Where does this tool fit in the improvement journey?


This tool is relevant at this stage of the Quality Improvement Journey.


It is also relevant to the three themes that support your journey.

How to use it

Start by deciding your start and end points, then the intermediate points along the way.  Most literature suggests around 10, but you will have to work to your own situation. Enter your data in the Data Capture sheet where indicated. Use the charts to explore your findings:

Patient Pathway graph


The patient pathways chart shows you all the pathways at a glance. 

From here you may be able to see a clear bottle neck by the prominence of one colour.

Patient Wait Graph


The Distribution of Waits shows a box and whisker chart for each of the touch points in your pathway.  Half of patient waits fall inside the box and half outside, with the line showing the median of waits.

The distribution can show you if there is a lot of variation in that particular step. The ideal step in a pathway will have little variation and be shorter.

Long "whiskers" show there are outliers, which could be one anomaly.  It is worth checking if these are unusual cases.

Resources to download