PROCESS MAPPING -

FLOWCHARTS OVERVIEW

© 2008 – Jesse Whiddon – All rights reserved

Process Flowcharts• Shows the basic work flow pathway drawn

according to supplier/customer relationships.

• Provides a “snapshot” picture of the process which provides a clear understanding of inputs, pathways, action or decision points and ultimately completion.

• It can serve as an instruction manual or a tool for facilitating detailed analysis and optimization of workflow and service delivery.

Patient arrives with requisitions and is instructed to sign in.

Patient is called into the drawing room.

Review requisition for accurate patient demographics with patient

Patient name, DOB, insurance okay and complete?

Is requisition hand written or electronic?

Make minor corrections on the handwritten requisitions

Clinic corrects problem, patient comes back and must start process over

Patient is sent back to the clinic for corrections on electronic requisitions

Are hand-written tests legible?

Call clinic office for verification of illegible tests that have been ordered

Are you sure of specimen requirements?

Go into outside lab database for specimen requirements

Collect appropriate specimens

PATIENT BLOODWORK PREPARATION FOR SURGERY PROCESS FLOWCHART

N

Y

Y

N

N

Y

Basic Flowchart Symbols

Process

Alternate Process

Decision

Terminator

Swim-lane Flowcharts

• A flowchart that focuses on the “who” in “who does what”.

• Shows who or what function is responsible for each step in the process…

Swim-lane Flowcharts

• Good at showing the handoffs between functions, groups, departments, etc.

• Especially good with administrative (service) processes.

• Very good at showing how delays, mistakes and cheating are most likely to occur.

SWIM-LANE FLOWCHART – COMPLAINT HANDLING

CUSTOMER

Submits Complaint (Samples?) to Quality Dept. at the Plant

Investigates and Sends to Proc. Mgr.

Writes Customer Response, Seeks Approval

Investigates for Root Cause, Sends back to Quality

Approval

Approval

SALES

QUALITY

LABORATORY

PROCESS MGR

Yes

No

Sends to Sales, Distribute Copies

Sends to Customer and Makes Phone Contact

Yes

Receives ResponseContacts Sales

STAFF MGR

PLANT MGR

Tests Samples, if needed

SWIM-LANE FLOWCHART – MAMMOGRAM PRIOR TO HOSPITAL ADMISSION

General Practitioner

Patient

Radiology

Surgeon

Hospital

Pathology

Radiological Oncologist

Medical Oncologist

Appt Phys-ical

Mammogram

Phys-ical

Appt

Appt Mammogram

Dev-elop

Send

Recv Con-sult

Con-sult

Appt

Con-sult

Con-sult

Sched Orders

Sched Orders

Con-sult

Con-sult

Con-sult

Con-sult

Transportation & Spaghetti Diagrams

• Diagrams that show the physical flow of work or material.

• Used to improve the physical layout of a work space.

Transportation & Spaghetti Diagrams

Desk Test Station 1 Test Station 2

Test Station 3

Door

Hallway1

2 3

4

5

6

1. Delivers Specimen

2. Picks up specimen

3. Returns and logs in base info

4. Carries specimen to test station 1, runs test

5. Carries specimen to test station 2, runs test

6. Carries specimen to test station 3, runs test & disposes.

7. Returns to enter test results.

7

Value Added Task

• It is an activity that is important to the patient so that the patient is willing to pay for it or it is absolutely essential to conduct business.

• People often confuse activity with value-added work.

• It changes what is being processed..

Value-added Task

• It is done right the first time with no waste or rework.

• It is value-added or it is waste (non-value added)

Value from the Patients Perspective

• Short or no wait time

• Timely reports

• Good and timely decisions

• Good outcomes

• Courtesy

• Reasonable costs

• Etc.

Value Process Flowcharts

• Similar to the basic process flowchart but incorporates symbols that identify value and non-value tasks.

• Are used to identify and then eliminate or reduce waste and to help improve value tasks.

To hospital

Wait in waiting room (20 min)

Admission by clerk (12 min)

Wait (1 hour)

To exam room (3 min)

History & exam by nurse (20 min)

To blood drawing room (2 min)

Draw blood (5 min)

To holding area (3 min)

Blood to lab Changes into gown (2 min)

Test blood Wait (5 to 10 min)

Blood work report to OR Prepping (5 to 25 min) Clean up & instrument removal (5 min)

Hold blood work report Wait (10 min) To recovery room (PACU) (3 min)

Surgery team pulls Premedication (15 min) Recovery (1 to 3 hours)

To OR (2 min) To hospital room (5 min)

Wait for blood work? (0 to 30 min)

Nurse checks Id/ lab data (3 min)

Anesthesiologist prep (10 min)

Surgery (1 hour)

Blood work flow

Patient flow

PRESENT STATE VALUE FLOWCHART

Value Flowchart Symbols

Operation

Transport

Handle

Inspect

Delay

Decide

Store

To hospital

Admission by clerk (3 min)

History & exam by nurse (10 min)

Draw blood (5 min)

Changes into gown (2 min)

Blood to lab Prepping (5 to 25 min)

Test blood Premedication (15 min)

Blood work report to OR Nurse checks Id/ lab data (3 min)

Anesthesiologist prep (10 min)

Surgery (1 hour)

Clean up & instrument removal (5 min)

Recovery (1 to 2 hours)

To hospital room (5 min)

Blood work flow

Patient flow

IDEAL STATE VALUE FLOWCHART

To hospital

Wait in waiting room (5 min)

Admission by clerk (3 min)

To blood drawing room (2 min)

Draw blood (5 min)

Wait (30 min)

Blood to lab To exam room (3 min)

Test blood History & exam by nurse (10 min)

Blood work report to OR To holding area (3 min)

Hold blood work report Changes into gown (2 min)

Pull when needed Wait (5 to 10 min)

Prepping (5 to 25 min) Clean up & instrument removal (5 min)

Premedication (15 min) To recovery room (PACU) (3 min)

To OR (2 min) Recovery (1 to 2 hours)

Nurse checks Id/ lab data (3 min) To hospital room (5 min)

Anesthesiologist prep (10 min)

Surgery (1 hour)

FUTURE STATE VALUE FLOWCHART # 1