Workflow Redesign

A Redesigned Workflow Diagram Program Transcript

INTRODUCTION: In Week 3, you watched a video entitled, A Gap Analysis Scenario. In this video you were introduced to an office that was experiencing difficulties with case flow management. In the case study, those in the physician’s office held a meeting to determine workflow issues that could be remedied. After discussing the current process of moving a patient through the system, the office staff identified the following workflow issues:

• Having a paper-based system only allows the chart to be sequentially accessed, so each step in the workflow depends upon the staff from the previous step to be finished with the chart.

• Copying the chart to avoid competition for the original causes delay and potential confusion among copies and the original

• Transcribing information to the chart can take up to 24 hours to process. • An entire position is devoted to processing charts. • Stacks of charts awaiting processing can lead to errors and additional

delay • Staff are unaware of significant changes in the chart until it reaches their

hands. This can lead to unannounced changes in workflow.

The Week 5 interactive media piece entitled “Current-State Workflow” provided a workflow diagram for the paper-based office highlighted in the Week 3 video on gap analysis. Now, in this interactive media piece, you will view an updated workflow diagram that displays how the workflow issues caused by the office’s paper-based system can be resolved through the implementation of an Electronic Health Record.

By clicking the “next” button, you will see the office’s current-state workflow diagram with its workflow issues highlighted.

WORKFLOW DIAGRAM WITH ASSESSMENT:

Assessment #1: A paper-based system allows only one person at a time to access the chart.

(diagram starts with)

Chart note for surgery is created. Chart transferred to front desk.

(arrow points to)

Front desk schedules operation at external facility. Chart transferred to preoperative lab.

(arrow points to)

Preoperative lab generates additional patient information to be transcribed. Chart transferred for transcription.

(arrow points to)

Assessment #2: Waiting on transcription processing slows entire workflow

Is preoperative lab information transcribed?

(no arrow points to)

Assessment #3: Copies can cause delays, errors, and confusion.

Chart is updated after transcription and transferred to specialist. Copy if needed.

(yes arrow from “Is preoperative lab information transcribed?” points to)

Chart transferred to specialist.

(arrow from “Chart transferred to specialist.” and “Chart is updated after transcription and transferred to specialist. Copy if needed.” points to)

Specialist reviews chart for clearance and transfers for transcription.

(arrow points to)

Assessment #4: Waiting slows workflow again.

Is specialist information transcribed?

(no arrow points to)

Chart is updated after transcription and transferred to front desk. Copy if needed.

(yes arrow points to)

Assessment #5: Front desk devotes large sums of time to processing charts.

Chart transferred to front desk.

(arrow points to)

Front desk contacts insurance company for treatment pre-certification.

(arrow points to)

Front desk generates surgical consent, health history, physical, and pre- and postoperative orders. Chart transferred to referring physician.

REDESIGNED WORKFLOW DIAGRAM:

Assessment #1: The previous paper-based system allowed only one person at a time to access the chart. The new EHR enables simultaneous access, no longer forcing staff to wait for previous staff members to have information transcribed. Confusion and delays caused by copies are also eliminated.

(diagram starts with)

Chart note for surgery is created and updated on electronic health record (EHR).

(arrow points to)

Front desk uses chart from EHR to schedule operation at external facility

(and)

Preoperative lab uses chart from HER and generates additional information to be transcribed.

(and)

Specialist reviews chart for clearance and generates additional information to be transcribed.

(arrow from “Preoperative lab uses chart from HER and generates additional information to be transcribed.” and “Specialist reviews chart for clearance and generates additional information to be transcribed.” points to)

Assessment #2: As the transcriptionist enters new information, staff can access it in real time rather than waiting for physical transcription, sorting, and transfer. This method enables greater awareness among staff of significant changes in a patient’s status.

Medical transcriptionist transcribes preoperative lab and specialist findings to EHR-based chart.

(arrow points to)

Assessment #3: The front desk no longer devotes staff to sorting through piles of charts. Errors and processing time are reduced. Front desk contacts insurance company for treatment pre-certification.

(arrow points to)

Front desk generates surgical consent, health history, physical, and pre and postoperative orders. Chart transferred to referring physician.

© 2012 Laureate Education, Inc.