Process Mapping

Documenting work flows, or process mapping, is a great way to get a new team started on a process improvement project. Process mapping traces an object through a cycle from start to finish.
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  • Guide
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REFERENCES

 

Bassard, M., Ritter, D.  (2010). The Memory Jogger 2. Tools for Continuous Improvement and Effective Planning.  Second Edition.  Salem, NH: GOAL/QPC

Handbook for Basic Process Improvement.  Flow Charts http://www.au.af.mil/au/awc/awcgate/navy/bpi_manual/mod6-flowchrt.pdf

Institute for Healthcare Improvement. “Flowchart”.  Retrieved from: http://www.ihi.org/resources/Pages/Tools/Flowchart.aspx. 16 May 2017.

Sollecito, W. A., Johnson, J. K. (2013). Continuous Quality Improvement in Health Care Fourth Edition.  Burlington, MA: Jones & Bartlett Learning.

Spath, P. L. (2013). Introduction to Healthcare Quality Management, Second Edition.  Chicago, IL: Health Administration Press.

White, S. V. (2012). Q Solutions: Essential Resources for the Healthcare Quality Professional.  Quality and Performance Improvement. Third Edition.  Glenview, IL; National Association for Healthcare Quality

REFERENCES

Introduction

The advantage of mapping a process as a group of inter-related steps is that you document the process from multiple perspectives.

As you map the “current state”, be sure to map the actual process rather than what any one individual thinks the process should be.

From this Current State, You Can:

  • Document the flow or sequence of events in a process
  • Compare and contrast the actual versus the ideal flow of a process
  • Detect unexpected complexity, problem areas, redundancies, unnecessary steps and opportunities for simplification
  • Come to agreement on the process steps
  • Use it as a training aid to understand the complete process

Materials You'll Need:

  • Sticky notes or index cards & tape
  • Markers, for writing on sticky notes or index cards
  • Large surface area (work table, flip chart, white board, blank wall)
  • Team members from all areas of the organization are involved in the process 

Mapping the Process - Current State

Select a Process to Map

For our example, we will use the Patient Flow in a Clinic. 

Select a Team

Select a team to work on the process map.

Define Starting and End Point

Clearly define where the process starts (input) and where it ends (final output).

Agree on Level of Detail

Agree on the level of detail to be shown to clearly understand the process and identify problem areas.

    • It’s sometimes easier to begin at the Macro level and then add detail once the macro level is agreed upon.
    • Macro level – reveals the high-level steps in the process.
    • Detail Level – Reveals finite actions and decision points.
      Flowchart depicting the patient journey through a clinical setting, from arrival to exit, with labeled process steps and arrows indicating the flow direction.
      Patient flow process showing sequential steps from arrival to exit during a clinic visit.

      Add Detail to Each Activity.

      Brainstorm a list of significant activities, inputs, outputs, and decisions from beginning to end. Use sticky notes or index cards to document each item.

      Example:

      • What are the steps the patient goes through at Registration? When Roomed?
      • What tasks are performed at each step?
      • Who performs these tasks? Document the job role or title, not an individual name.

      Order the Steps

      Sequence the steps in the order they are carried out.

      Validate Accuracy

      Validate the accuracy of the flow chart.  If you are unsure of the process, you may:

      • Interview people who execute the process
      • Shadow through a process with direct observation

      Process Map

      Draw the Process Map using symbols.
      A reference image showing standard flowchart symbols including beginning point, process step, decision, connector, and terminal point, each represented by a different shape.
      Common flowchart symbols used to map out processes in diagrams.

      Memorialize the Process Map by taking a picture and/or documenting it on the computer.

      • Name and date the Process
      • Add the names of all participating Team Members 

      Improving the Process - Ideal State

      Evaluate the Process Map for Improvement Opportunities. Ask these Questions:

      • How can we better serve our patients and customers?
      • What steps can be eliminated?
      • What steps can be combined with others to achieve a specific goal?
      • Which steps can be simplified?
      • Which rework loops can be eliminated?
      • Can the build-up of paperwork be minimized?
      • Which handoffs between people or departments can be streamlined?

      Create a Second Process Map that Illustrates the Ideal Process

      What is the best way to proceed from start to finish?

      Determine Actions Necessary to Move From the Current State to the Ideal State

      • Permissions needed?
      • Resources needed?
      • Training needed?

      Utilize a Process Improvement Methodology

      Utilize a Process Improvement Methodology such as PDSA (Plan-Do-Study-Act) to make improvements.

      How Can We Help Your Team Work?