Saturday, August 08, 2009

Want to find in-efficiencies? Make a flow chart.

I serve on my hospital's performance improvement commitee. I enjoy it and I learn from it. Here is something I learned from my hospital's PI committee.

If you want to find sources of error, flow-chart your processes. It can go something like this for a small office like mine.

Let's say you want to find a weak spot in your diagnostic test ordering and resulting process; FLOW IT OUT
  1. Patient needs "blood test."
  2. Complete requisition (paper for sake of argument)
  3. Give requisition to MA to facilitate

  4. She draws the blood, processes it, ie centrifuge, and places it in the pick-up box with requisition attached

  5. Lab recieves, runs the lab

  6. Results are faxed and mailed to office (partials first, then finals)

  7. Result placed on doctors desk for review and signature
  8. Result then given back to staff for placement in chart, unless doctor needs chart pulled to interpret test
  9. Patient informed
  10. Chart re-filed

If you go through this simple list of steps, you can see lot's of inefficies. For example;

  • Step 2: WARNING: MAJOR SOURCE OF ERROR HERE: handwriting issues and duplication of data: an electronic ordering system can correct this. Contact your labas they may be able to install one for you at no charge, even.
  • Step 6: Duplication of results, wasted time and effort as doctor needs to sign-off on the same lab multiple times. Plus cost of tonor, printer/fax usage, staff time,and doctor frustration factor, there is a better way. Simply ask the lab to only send complete reports and better yet, ask them to automatically download those results from their server to yours and to notify you when done. Most good labs can do this easily and at no charge to you.
  • Step 7: Automating step 6 makes steps 7, 8, and 9 obsolete.
  • Step 9: Normals can be mailed to patients using a form letter.
  • Step 10: Electronic records obviously elliminates this step plus step 8 as well.

You can do this for almost, if not every, process that takes place in your office.

Try it.