PROCESS MAP TOOLKIT

1. PROCESS MAP TOOLKIT

2. EXAMPLE 1: PATIENT WAIT TIME PROCESS FLOW Patient arrives at clinic No Patient services representative (PSR) gives patient paperwork for review & signature and takes patient’s insurance card & ID Patient waits while physician works with medical assistants & nurses to obtain information After completing paperwork, patient waits for available PSR to complete check-in Patient waits for physician to enter & start visit Patient waits for medical assistant Patient leaves clinic Yes Patient waits while physician works with medical assistants & nurses to place and validate orders PSR collects copay and returns cards to patient, completing check-in Patient receives referrals, orders, after-visit summary and instructions, schedules follow-up appointments as necessary and completes check-out Yes No Medical assistant takes patient back on “first ready” basis, takes vitals & updates history and completes medication reconciliation Diagnostic test is completed Patient has encounter with physician Additionaldocuments required? Diagnostic tests,labs and/or outsiderecords? Are additional diagnostics required in the office? Patient waits for physician to return with results Patient waits for available PSR in check-out area Patient discusses plan of care with physician Terminal point Process Delay Decision Improvement opportunities

3. EXAMPLE 2: PRE-VISIT PLANNING PROCESS Receptionist schedules follow-up appointment(s) for the patient before they leave the office Medical assistant orders labs based on standing orders Medical assistant schedules labs to be completed before the next appointment Use a visit planner checklist to arrange next appointment(s) Patient is at the office for their current visit DURING THE CURRENT VISIT Yes No Consider a pre-visit phone call or email to begin medication reconciliation, set the patient agenda and perform other preparations to ensure that the visit is thorough and efficient • Medical assistant performs visit preparations: • Reviews notes from prior visit and confirms that documentation from interval care or hospitalizations has been obtained • Prints copies of lab results and other important results to discuss at visit Use a visit prep checklist to identify gaps in care, such as immunizations or cancer screenings. If something needs to be scheduled before the upcoming visit, contact the patient to schedule the appointment Yes Send patients appointment reminders, either automatically or manually Does the patientneed to have any lab work or other diagnostics done before their next appointment? BEFORETHE NEXT VISIT Is the patient considered complex? Patient has pre-visit labs completed No Medical assistant rooms patient and updates patient record based on information on pre-visit questionnaire, conducts medication reconciliation and sets visit agenda with patient Hand off the patient to the physician, informing them of the purpose of the patient’s visit as well as any important information learned during rooming Hold a pre-clinic care team huddle to prepare the team for the day ahead and anticipate any patient needs Physician portionof visit begins.Pre-visit planning commences at the “current visit” Receptionist hands out a pre-appointment questionnaire to each patient at check-in DURINGTHE NEXT VISIT Preparation Document Terminal point Process Decision

4. MOST COMMON PROCESS MAP SYMBOLS Which symbols should you use? Most process maps can be created using a few basic flowchart symbols. Here are some common symbols and their meanings. To create your own map, copy and paste these symbols into a new slide.

5. CONNECTORS Connectors are lines that link different flowchart symbols. Once placed, connectors will stay connected to the symbols they are linked to. Move linked symbols and their connecters will automatically reorient with them. Swim lanes can be used to delineate roles and responsibilities within your practice. Lanes can be arranged horizontally or vertically. See EXAMPLE 2 for swim lane element.