Flowcharting

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Flowcharting

• Paul King
• V. U. School of Engineering

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Overview

• This Lecture will overview flowcharting of
  processes.
• Elementary to detailed charting will be covered.

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Why Flowchart???

• Document the process.
• Allow study of roadblocks
• Allow display of timing conditionals.
• Provide a communication tool.

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Examples to follow

• Hinge Manufacture
• Hypertension Clinic 1
• Hypertension Clinic 2
• The ideal?
• ABET Diagram
• Breast Cancer Clinic.

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Hypertension Clinic - Flow Study 1

• Patient enters, signs in, waits in waiting room
  until called
• Patient goes to weigh-in room, weight pulse
  rate taken, medications reviewed (RN).
• Patient goes to new waiting room.
• Patient is sent to room, put on bed, lights out,
  2 minute wait, BP taken (RN).
• Patient to waiting room
• Patient to clinic room ...

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Hypertension Clinic - Flow Study 1, Continued

• Patient interviewed by MD or Resident/MD, BP
  taken?
• Patient medications reviewed, lifestyle, needs.
• Patient discharged rescheduled and tests
  ordered if necessary or admitted...

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Flowchart Hypertension Clinic 1
Delay 1 2-10Delay 2 2-20Delay 3 5-20Delay 4
5-20
Overall waiting time 14-70
Actual patient interaction 7
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Discussion

• Using delay symbols for patient wait states
  stresses delays
• Each delay is in fact a wait for event,
  simplified here.
• Waiting times may be expressed as here, or as
  color bars for easy identification of outlier
  cases
• Actual overall waiting times have ranged up to
  100 minutes

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Flowchart Hypertension Clinic 2
Delay 1 2-10Delay 2 2-20Delay 3 5-20
Overall waiting time 9-50
Actual patient interaction 7
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Discussion

• Using delay symbols for patient wait states
  stresses delays
• Overall delay time has dropped.
• Delay 2 3 may be combined...
• Actual overall waiting times have decreased

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Future Clinic Structure?
Time in-out 7-20
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Discussion

• While the chart is more complicated, the process
  is easier for most patients.
• MD time is utilized for needy patients.
• RN time is used for less needy.
• Many patients will be status quo.
• This is approximately the dentist office model..

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The Two Loops of EC2000
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Discussion

• Flowcharting in this fashion is far more powerful
  than the written text.
• Flowcharts can be used to make a point of
  interactions between several factors.

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Typical Undergraduate Flowcharting Project

• Breast center, 50 patients a day
• Categorize (normal v next step)
• Interview a subset
• Observe interactions and flow over three months
• Walk through the problem.
• Interview staff.
• Flowchart data, analyze data, recommend changes.

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PATIENT FLOW ANALYSIS OF VANDERBILTBREAST CENTER

• Michelle E. Kandcer, B.S.
• Doris Quinn, PhD, Advisor

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PROJECT DEFINITION

• The goal of this project is to assess and to
  improve the patient flow process in Vanderbilts
  Breast Cancer Center. Patient responses will be
  of significant consideration.

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OBJECTIVES

• To create a flowchart in (Micrografx Flow-Charter
  7.0) that will describe the current patient flow
  process.
• To highlight weaknesses of the process.
• To emphasize (on the flowchart) patients
  feelings regarding the process.
• To make suggestions as to how to improve the
  current process.

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SIGNIFICANCE

• The American Cancer Society estimates that
  178,700 women will be diagnosed with breast
  cancer this year alone and that 3,900 of these
  women will be from Tennessee. Furthermore,
  another 43,500 women will die because of this
  disease.
• Currently, more than 50 women per day utilize
  services provided by the Cancer Center.

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WORK COMPLETEDFlow of Pre -Registration
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WORK COMPLETEDFlow of Registration
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WORK COMPLETEDProcess Flow for those Needing
Mammograms
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WORK COMPLETEDProcess Flow for those Needing
Mammograms (continued)
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WORK COMPLETED Process Flow for those
NotNeeding Mammograms
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WORK COMPLETED Process Flow for those
NotNeeding Mammograms (continued)
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Summary

• Flowcharting works!.
• Flowcharting is a useful tool.