Flowcharting Medical Processes

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Flowcharting Medical Processes

• How to Draw Flowcharts

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Purpose of Flowcharting

• Show the steps involved within the process.
• Determine where delays are, their causes, how to
  reduce them.
• Aid in communication of thoughts, ideas, and
  procedures.

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Basic Flowcharting Shapes

• The terminator symbol marks the starting or
  ending point of a system.
• The delay symbol marks a delay in the system
  showing that the next occurrence is not
  instantaneous.
• The decision symbol marks a decision or branching
  point. Decisions are always binary (i.e. yes or
  no).
• The process symbol can represent a single step or
  an entire sub-process.
• Lines indicate the sequence of steps and the
  direction of flow.

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Basic Flowchart
The above is an example of a basic flowchart.
Like most things, flowcharts can be simpler or
more complex.
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Developing a FlowchartHere is an example of
flowcharting in a clinic.
A flowchart always starts with a terminator,
usually the terminator is a process however, it
can sometimes be associated with a decision that
has only one result.
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Handling Delays Within a Process
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Decisions, Decisions, Decisions
Decisions are important in determining what path
to follow as a result of previous events. In the
example above, as long as the info has not been
gathered, the patient continues to wait in the
waiting room.
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Actions and Processes
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And the Clock Keeps Ticking
Notice the additional delay of the waiting room,
that the process Gather Info leads to another
delay instead of the previous delay. This negates
the need to Gather Info again, as it has
already been gathered.
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Got Nurse?
As can be seen from this diagram, choices
directly relate the path that the remainder of
the system passes. In this example notice that if
no nurse is available the patient remains in the
waiting room.
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Obtaining Vitals
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Whats Next?
This shows a branching of the overall process.
What happens if the exam room is not available?
What does the patient do if the room is available?
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Were Off to See the Wizard, or are We?
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More Waiting!?
Delays show that the system is not flawless,
reducing the number and length of delays improves
patient discharge time.
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Medicine Update
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All I Ever Do is Wait.
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Is There a Doctor in the House?
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FinallyResults.
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Lets Go Home
A flowchart usually ends with a terminator,
designating the end of the process. However,
occasionally, the flowchart will end with a
decision if it is necessary to complete the
process again after the process has been
completed.
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Looking Back
Total Wait 17-80 min. Total Interaction 10 min.
The delay times and the process times have been
overlaid here to allow for interpretation of time
spent in each stage of the process.
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Designing a Better Flowchart

• Determine the weaknesses of the system and how to
  improve efficiency.
• What is the best method to reduce delays?
• Does every patient need to see the MD?
• Does every patient need to see a RN?
• Design choices to progress in parallel branches,
  where returning to a previous step is minimized.