Subject
Topic Creating workflow chart/Workflow Analysis
Type Essay
Level College
Style APA
Sources 8
Language English(U.S.)
Description
Directions
Creating workflow chart/Workflow Analysis
Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.
Purpose
The Purpose of this assignment is to:
- Understand the benefits of nurse workflow analysis in improving clinical and administrative performance using standard flowcharting symbols and rules.
- Compare and contrast the benefits of information technology and process improvement to enable nurse workflow and improve clinical and administrative outcomes.
Directions
- Review the brief description of the workflow in primary care clinic for a typical patient visit using electronic medical record.
- Review standard flowchart symbols at the following website: http://www.breezetree.com/articles/what-is-a-flow-chart.htm
- Using the flow chart symbols in Word (Insert => Shapes => Flowchart Symbols) develop a flowchart of a typical patient visit from the time the patient schedules an appointment, completes the visit, and leaves the clinic using the format in Figure 1 (remember this is just an example):
- Review the Key Workflow Problems listed after the Description of the Workflow for a Primary Care Clinic.
- Write a narrative summary (no longer than 3 pages, 12 point font, double spaced excluding references and title page) that describes how information technology could address each of the workflow problems. For example; clinical decision support systems integrated into an electronic health record can alert users to potential drug allergies or e-prescription can eliminate the need for paper prescription pads. Make sure to not only identify what the information technology is, but how it will improve workflow and clinical or administrative outcomes.
.
- Consider how you would design a flowchart to represent the current workflow.
- Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.
- Next, in the paper:
o Explain the process you have diagrammed.
o For each step or decision point in the process, identify the following:
? Who does this step? (It can be several people.)
? What technology is used?
? What policies and rules are involved in determining how, when, why, or where the step is executed?
? What information is needed for the execution of this step?
o Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?
o Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.
o Summarize why it is important to be aware of the flow of an activity.
- Revise your current flowchart to integrate the new information technology and new process flow. An excellent resource for this project is listed at the Office of the National Coordinators website at http://www.healthit.gov/providers-professionals/frequently-asked- questions/411#id80 . These include two PowerPoint presentations entitled, “Workflow Process Mapping for Electronic Health Records” and “Workflow Redesign Templates”.
Figure 1
Example of Clinic Flowchart Format
Appointment Scheduling Workflow Template
Clerk or Provider
Patient needs appointment
Scheduler
New Patient?
Yes
Create new record in system
Appointment Scheduled
No
Search for patient in system (MRN, Name, DOB, etc.)
Enter patient information
Select provider and Open appointment schedule
Summarize appointment verbally or give appointment card
Select Reason or Type of Appointment
Search for specific date or next available appointment
Select appointment slot(s) and save
Office Visit Workflow Template
Patient
Arrives &
checks in
Nurse/Support
Views EHR schedule & patient “arrived” status
Greets patient and escorts to clinic area
Obtains patient’s weight, height, blood pressure, temp., etc.
Escorts patient to exam room & logs into EHR
Secures workstation and leaves room
Select & open patient’s electronic record
Record history: past medical, social, family, substance (smoking history), etc.
Enters vitals MU Objective:
& chief Record and chart
complaint changes in vital signs
Verify & MU Objective:
record Maintain active
allergies & medication &
current medication allergy list
medications
MU Objective: Record smoking status for patients 13 years old
or older
Provider
Performs chart review before entering exam room
Closes the encounter in EHR
Enters the room, greets patient, and logs onto workstation
Consults with patient and records HPI
Provides patient with instructions/ materials
Performs physical exam
Assigns Level of Service (LOS)
Documents review of systems & physical exam into EHR
Places orders as necessary (see Orders workflow)
Updates problem list & triggers CDS rules if needed
MU Objective: Maintain problem list of current and active diagnoses & implement relevant CDS rules
Sample:
WORKFLOW FOR A PRIMARY CARE CLINIC
WITH A PAPER MEDICAL RECORD
The typical workflow for a patient visit at this primary care clinic begins with the patient intake portion which includes the request for appointment, patient registration, history taking and beginning the clinical exam. The patient contacts the clinic for an appointment via phone call or in-person for a walk-in appointment, taken as available. In both instances, the receptionist collects demographic data from the patient, including date of birth, age, address, social security number, emergency contacts and insurance
provider information. This information is entered into the demographic and insurance component of the clinic’s electronic registration system.
New patients are scheduled for a forty-five minute appointment and receive a unique patient identification number (ptID). This number remains the same for the life of the patient at the clinic. A returning patient’s information is retrieved, including the ptID, and is scheduled for a twenty minute appointment.
After the patient is scheduled and registration is complete, a new paper chart is developed by the file clerk and the registration information is printed and placed in the chart. If the patient is a returning patient the file clerk pulls the existing paper record from the file room, updates the demographic information and then places the chart in the pending charts bin. The day before the patient arrives for their appointment, the file clerk places the paper chart at the front desk so that it is available when the patient arrives for their appointment.
Upon the patient’s arrival, the receptionist queries the patient’s social security number and verifies the patient’s identity with their last and first name. Demographic information is validated or updated in the registration system. The patient then receives a paper encounter form, requesting information on past medical history, current health concerns and reasons for visit, to be completed while waiting to be placed in an exam room. In the meantime, the nurse is alerted that the patient has arrived and when available, rooms the patient in an exam room in the clinic.
The second portion of the workflow includes: the physician’s physical exam, patient laboratory, radiologic and other testing, and patient discharge. Once the patient is in the exam room, the nurse reviews t
