Figure 8. Sample Top-Down Format: Laboratory Test (Text Description)

A Toolkit for Redesign in Health Care: Final Report

Figure 8 is an example of a top-down format map. It shows the activities, people, and their roles in a process. This example illustrates the steps that occur between ordering a laboratory test and recording results in the medical chart. It also shows which person does each task.

The left-most column lists the steps in the process. Each row presents a separate step. The columns to the right list persons in the process. Column 2 is nurse/resident/physician. Column 3 is phlebotomist. Column 4 is transporter. Column 5 is lab tech. Column 6 is physician.

The process begins with Step 1, which is Blood draw ordered. An arrow is drawn horizontally from Column 2, which is the nurse/resident/physician who orders the test, to Column 3 which is the phlebotomist who receives the order. The arrow is then drawn vertically down through the next four steps which are performed by the phlebotomist:

• Step 2 is: Phlebotomist receives blood order for printout from the POE (point of entry).
• Step 3 is: Phlebotomist checks with nursing station on the floor.
• Step 4 is: Blood draw taken.
• Step 5 is: Blood draw recorded.

For Step 6: Blood draw transported to lab, the arrow is drawn horizontally from phlebotomist to transporter. For Step 7: Blood draw received and analyzed by lab technician, the arrow is drawn horizontally from transporter to lab tech.

Since the laboratory technician enters the results in the laboratory information system, a vertical arrow is drawn from Step 7 to Step 8: Results entered into MYCIS (the lab information system). For Step 9: Results entered into patient medical chart, ready for physician to review, a horizontal arrow is drawn from lab tech to physician. This completes the process.

Note: Data in this chart are for illustrative purposes only.

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