Why “Swimlane?” Swimmer’s platform Swimming pool Michael Phelps The “swimmer” stays in their lane. Only the patient moves from one lane to the next. Ryan Lochte In the “ineffective workflow” example on page 8, no one has a lane. Roles are hard to identify, and everyone is in the pool at what seem to be random places and at the same point in time. Decision points are not identified and there are multiple lines drawn from the same shapes, and shapes are used that are subject to interpretation. It very difficult to even understand what is going on, let alone effectively analyze it. DEFINE WORKFLOW _______________________________________________________________________ Role Activity
Document Tracking Revisions Date Changes Author/Editor Initial Draft 3/23/2012 First draft of all “Managing Patient Contacts” Business Process Analysis Jane Doe Revision 1 4/2/2012 Additional comments were included after clinical staff and medical staff analysis John Smith, Clinical Director Mary Black, Medical Director Revision 2 4/9/2012 Inserted comments re: improving billing revenue Jim Dean, Financial Director Revision 3 4/15/2012 Approved final “As Is” Analysis Chris White Executive Director
2 Mental Health Professional Refers to Wellness Educator for screening Unnecessary step. If MH professional knows requirements, can screen at that time Recommend MH professional familiar with program and conducts screening. 3 Wellness Educator Conducts screening Referrals do not show up as expected, spending time on follow up, cant contact. Can task be accomplished by MH professional at time of Get baseline for # of no shows, and time spent in follow up. Recommend MH professional conducts screening 4 Wellness Educator Determines eligibility Yes Obtains consents and other documentation Confirm consents are necessary. May not be under HIPAA. MH professional can obtain at time of determination. 5 Wellness Educator Determines eligibility No See “Not Eligible” Workflow. How is referral loop being closed with MH professional? The patient should not have to come into the clinic a second time only to be told not eligible. 6 Wellness Educator Sees if nurse care manager is available 1. Yes Warm hand off. Care Manager. How often does this happen? Is there any reason that the MH Professional can’t make handoff? If yes, any reason they can’t make appointment for patient for primary care? Get baseline data on availability of care manager. Free up valuable Nurse time (nurse is actually a nurse practitioner) to see more patients by removing responsibilities that can be conducted by less expensive staff. Eliminate barrier of Wellness Educator. 7 Wellness Educator Sees if nurse care manager is available 1. No When not available, appointment, usually a week out since nurse office Get baseline for no shows for Nurse Care Manager Appointment. Maintain
hours are only Mon. and Wed. Not sure how many patients are lost in this interval. focus on maximizing the services of nurse practitioner to see more patients 8 Nurse Care Manager Collects NOMs Nurse practitioner is also entering NOMs data into TRAC. Tasks do NOT match credential and licensing, are impacting availability to patient. Reassign Tasks 9 Nurse Care Manager Collects vitals Nurses office and room vital signs are collected two different spaces. Handwrites data then enters into EHR Consolidate space. 10 Nurse Care Manager Collect samples Poor physical space, does not support this workflow. Blood glucose not fasting sample. Revise space to better support workflow. Use HgA1c test for glucose. 11 Nurse Care Manager Makes appointment for patient to see PCP Appointments are at least one week out. Some patients do not show. Spending time on calling and tracking down patients. 2 different locations. Reassign task of making PCP appointment and free up time. Get baseline of patient no shows. Pilot Peer Support Specialists participation in helping patients make appts. LIST THE FORMS (OR SCREENS) AND REPORTS THAT DRIVE THE PROCESS Form Name Where the form appears in the workflow (Line #)