Module 5 Appendix

Mapping and Redesigning Workflow

A Guide on Workflow Mapping


 

Contents

Slide 1. A Guide on Workflow Mapping
Slide 2. Learning Objectives
Slide 3. Workflow Mapping
Slide 4. Use for Workflow Maps
Slide 5. Types of Flowcharts
Slide 6. Common Symbols
Slide 7. What it Looks Like. Example: The Process of Buying a Box of Cereal.
Slide 8. What it Looks Like. Example: The Process of Buying a Box of Cereal
Slide 9. What it Looks Like. Example: The Process of Buying a Box of Cereal
Slide 10. Flowchart of Previsit Work and Appointment Scrubbing
Slide 11. Who is Involved?
Slide 12. The 6-Step Process
Slide 13. Know Your Process Template
Slide 14. Impact and Complexity Grid
Slide 15. Scheduling PCP Follow-up Appointments for Patients Prior to Hospital Discharge
Slide 16. How To Analyze My Map
Slide 17. Tips on Mapping
Slide 18. Workflow Mapping Exercise
Slide 19. Questions to Ask
Slide 20. In Conclusion
Slide 21. Remember
Slide 22. Thank You!
 


 

Slide 1. A Guide on Workflow Mapping

Alternative text is below the image

LA Net Community Health Resource Network
A Practice-Based Resource Network

Return to Contents


 

Slide 2. Learning Objectives

Alternative text is below the image

  • Identify the three types of flowcharts.
  • Explain the use for flowcharts.
  • Apply the six steps used to produce a flowchart.
  • Evaluate an organizational process using your flowchart.

Return to Contents


 

Slide 3. Workflow Mapping

Alternative text is below the image

  • Workflow maps are also referred to as flowcharts, flow maps, flow diagrams, flow sheets, and process maps.
  • A workflow map is defined as a visual representation of a process.
  • A process considers a sequence of operations with a start and end point.

Image of a hand drawing a flowchart.

Return to Contents


 

Slide 4. Use for Workflow Maps

Alternative text is below the image

  • To map current practice flow.
    • Are we really doing what we say we do?
  • Begin to identify areas for process improvement.
  • Visual aid and representation of roles and responsibilities.
  • Add on to an organization’s policies and procedures.
  • Process maintenance.

Return to Contents


 

Slide 5. Types of Flowcharts

Text description is below the image

  1. High-level flowchart: is a diagram that provides a brief overview of a process only highlighting major events in the process.
  2. Detailed flowchart: is a map that marks every step in a process, which includes decision points, waiting periods, and feedback loops.
  3. Swimlane flowchart: is a map that displays processes carried out for multiple roles across multiple stages.

Return to Contents


 

Slide 6. Common Symbols

Alternative text is below the image

Oval → Start/End
Rectangle→ Operation
Diamond → Decision
Pentagon → Delay
Arrow → Direction
Oblong → Connection
 

Return to Contents


 

Slide 7. What it Looks Like. 

Alternative text is below the image

Example: The Process of Buying a Box of Cereal

High-Level Flowchart
Diagram of steps to buy cereal: Arrive at the grocery store, walk to the cereal aisle, pick up a box of cereal, walk to cashier with cereal, pay for the box of cereal.

Detailed Flowchart
Diagram of steps to buy cereal: Arrive at the grocery store, walk to the cereal aisle, decide on cereal (Corn Flakes or Honey Oats), pick up a box, walk to cashier with cereal (if Honey Oats, give cashier coupon), pay for the box of cereal.

Return to Contents


 

Slide 8. What it Looks Like. 

Alternative text is below the image

Example: The Process of Buying a Box of Cereal

Swimlane Map

Detailed flowchart showing the activities of the customer and cashier. Customer arrives at the grocery store, walks to the cereal aisle, decides on cereal (Corn Flakes or Honey Oats, picks up a box of the chosen cereal, walks to the cashier with the cereal, and places the box on the belt. For Honey Oats, the customer gives the cashier a coupon and cash. For Corn Flakes, the customer gives the cashier cash.

Return to Contents


 

Slide 9. What it Looks Like. 

Alternative text is below the image

Example: The Process of Buying a Box of Cereal

Swimlane Map

The cashier’s process starts when the customer places the box on the belt. The cashier takes the box from the belt, scans the box code, states the final price, receives cash and coupon, and gives customer change. The “swimlanes” link the customer placing the box on the belt to the cashier taking the box and link the customer giving the cashier cash to the cashier receiving cash.

Return to Contents


 

Slide 10. Flowchart of Previsit Work and Appointment Scrubbing

Alternative text is below the image

Detailed flowchart of Previsit Work and Appointment Scrubbing.

This is an example of what is referred to as a “swim lane map.” A swim lane map displays processes that are carried out for multiple roles across multiple stages. Each swim lane is representative of a role, in this case: PCP, Clerk, LVN. The stretch of each lane is marked by the stages in the process. Here they are marked in the following order: 1) Appointment list review, 2) Appointment status, 3) Scrubbing.

Return to Contents


 

Slide 11. Who is Involved?

Alternative text is below the image

Involve all those who play a part in the process.

Tips:

  • Start with a small group if it’s a challenge to start with the entire group.
  • Pick a champion for this group.
  • Be sure to have all materials on-hand.
  • Provide the team with an overview of what the mapping process looks like.
  • Clearly state the objective and process selected for this exercise.

Return to Contents


 

Slide 12. The 6-Step Process

Alternative text is below the image

Step 1: Identify a process to map (use the Know Your Process template).
Step 2: Begin with a high-level flowchart.
Step 3: Move into a detailed flowchart.
Step 4: Walk through the process once or twice.
Step 5: Validate the maps to ensure they truly reflect the current process.
Step 6: Identify quick fixes and distinguish them from larger fixes (use LA Net’s Impact & Complexity Grid).

(REMEMBER: A flowchart captures the process AS IS, not how it is supposed to be)

Return to Contents


 

Slide 13. Know Your Process Template

Alternative text is below the image

Worksheet to rate core and supporting processes. The first column of this table lists Processes (e.g., Answering phones, Messaging, Billing/Coding). The rest of the columns are for staff to rate the processes (works well, not a problem, small problem, real problem, totally broken, cannot rate, we’re working on it, source of patient complaint). This worksheet should be used to identify areas for improvement. Each process should be flowcharted and possible improvements explored.

Return to Contents


 

Slide 14. Impact and Complexity Grid

Alternative text is below the image

  • Build Complexity:
    • Low Complexity/High Impact.
    • Low Complexity/Low Impact.
  • Next Stage:
    • High Complexity/High Impact.
  • Avoid Option #4:
    • High Complexity/Low Impact.
 Low ImpactHigh Impact
High ComplexityHigh Complexity/Low Impact
(Option #4)
High Complexity/High Impact
(Option #3)
Low ComplexityLow Complexity/Low Impact
(Option #2)
Low Complexity/High Impact
(Option #1)

Return to Contents


 

Slide 15. Scheduling PCP Follow-up Appointments for Patients Prior to Hospital Discharge

Alternative text is below the image

Detailed flowchart moving from resident writing discharge note through resident getting information about follow-up appointment. If no appointment info, patient given discharge instructions without follow-up appointment. If follow-up appointment info, patient given discharge instructions with follow-up appointment. The chart notes various steps and decision points, such as whether the attending wrote a note with follow-up appointment in it.

Return to Contents


 

Slide 16. How To Analyze My Map

Alternative text is below the image

You can use your process map to assess problem areas or potential areas for improvement by examining some of the following:

  • Bottlenecks and other sources of delay.
  • Rework due to errors.
  • Role ambiguity.
  • Duplicated efforts.
  • Unnecessary steps.
  • Sources of waste.
  • Variation.
  • Hand-offs.

Return to Contents


 

Slide 17. Tips on Mapping

Alternative text is below the image

  • Be sure to map current process.
  • Get key players involved and their input.
  • Recognize that any flowchart will take multiple attempts to complete.
  • Leverage existing experts and experiences.

Return to Contents


 

Slide 18. Workflow Mapping Exercise

Alternative text is below the image

  • Break into groups of 5 to 6
  • Be sure to have:
    • Poster board paper.
    • Post-its (or 5x6 index cards).
    • Marker.
  • Pick a leader and a scribe
  • Ground rules:
    • State process: Making coffee.
    • Define beginning and end points.
    • Assumptions: you already have coffee, a coffee pot, and you do not have a Keurig.

Return to Contents


 

Slide 19. Questions To Ask

Alternative text is below the image

  • Who knows what a workflow map is?
  • Who has experience in workflow mapping?
  • Did you consider your start and end points? What were they and how did your team come to this conclusion?
  • How did you deal with process agreements/disagreements?
  • Did everyone have input? If not, why?

Return to Contents


 

Slide 20. In Conclusion

Alternative text is below the image

  • The 3 types of flowcharts include: High-level, Detailed, and Swimlane flowcharts.
  • Flowcharts are used to map current processes, identify barriers and opportunities to increase efficiency, and to train newly hired staff of a process.
  • There are 6 major steps in mapping a flowchart.
  • There are a series of questions that need to be discussed after you develop your map that ask about repetition, role maximization, and decision points.

Return to Contents


 

Slide 21. Remember

Alternative text is below the image

Workflow maps serve as a tool to improve care for patients, improve efficiency in practice, and redistribute work and job responsibilities.

Cartoon of a complicated flowchart of workflow design. Two women are looking at it and one points to the bottom box and says, "And this is where our ED workflow redesign team went insane."

Return to Contents


 

Slide 22. Thank You!

Alternative text is below the image

LA Net Community Health Resource Network
3940-B East Broadway, Long Beach, CA 90803
Phone: 562.434.2000
www.lanetpbrn.net

Return to Contents

Return to Module 5

Current as of June 2013
Internet Citation: Module 5 Appendix: Mapping and Redesigning Workflow. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod5appendix.html