Flowchart Processes

Once you have selected something to improve and determined what the gap is, it's now time to figure out what clinical and administrative processes are involved with your chosen topic.  It's important to find a scope that's reasonable - you cannot describe all of the clinical care for hypertension or diabetes in a single process.  Instead, narrow it down a bit.

For congestive heart failure, for example, you could examine several processes:

• medication refill process

• clinic visit process

• the patient's process for reporting home measurements

• the transition-of-care process after heart failure admission

The examples above are more focused and more accessible to work on.  No boiling the ocean!

The next step is to UNDERSTAND that process for your team.  You may have an idea of what that process is, but your understanding could differ from everyone else on the team.  Your tools for this step are either a FLOWCHART or a SWIM-LANE diagram.

With your team, create a flowchart/swim-lane diagram of the process you select above.  It's always best to use the patient's perspective in creating this chart - what do they go through in getting a refill, or when they come to the clinic?

See here for information about CREATING FLOWCHARTS

See here for information about CREATING SWIM-LANE DIAGRAMS

Make sure to note areas, as you're constructing one of these diagrams, where there is variation or where different people seem to do things differently.  We will look at this variation in the next step - Understanding Variation.