understanding process heidi johns quality leader bcpsqc april, 2013
TRANSCRIPT
UNDERSTANDING PROCESS
Heidi JohnsQuality LeaderBCPSQCApril, 2013
Objectives
What are processes and why are they important to systems?
Various ways to communicate processes.
What is Mapping and when to use these techniques.
Avedis Donabedian
“Another approach to assessment is to examine the process of care itself rather than outcome.”
Avedis Donabedian, Evaluating the Quality of Medical Care, Milbank Quarterly. Volume 83, Issue 4
What is a Process?Process is NOT the system [structure].
A system allows for process.
A system is made up of processes.
In simple terms processes are sequences of actions with:
Inputs + Process = OUTPUT
OUTPUT
INPUT
PROCESS
What is process mapping?
“shows people what their jobs are and how they should interact with one another… describes the flow of materials, information and documents, displays various tasks contained within the process [and] indicates the decisions need[ed] “
» www.cps.gov.uk»
Why understand process – the benefits
Reduces Assumptions
Improves Clarity
Enhances Linkages
There is no substitute for knowledge."-W. Edwards Deming
Process Difficulties !!!
Why understand process - the difficulties • Can be biased
• Too much time stuck in details
• Language barriers
• Mixed groups
Process tools
There are various tools available to evaluate a process.
Process Analysis tools• Fault Tree Analysis• Relationship Maps• Cross- functional Process Maps [swim lane]• Value Stream Mapping [will be discussed in LEAN]• System Mapping• Patient Journey Mapping• Touch Point Mapping
Fault Tree Analysis [FTA]
• Deductive approach• Regressive looking• Uses symbols• Relationship of events
To design systems that work correctly we often need to understand and correct where they can go wrong.
Dan Goldin, NASA Administrator, 2000.
Fault Tree Analysis Diagram
Relationship Diagrams/Mapping
• Visual representation of parts of the organization
• What the organization produces
• How work flows Internal or external supplier-customer relationships
Source: Robert Damelio, The Basics of Process Mapping
Relationship MapWhat does this map show you?
Source: Robert Damelio, The Basics of Process Mapping
Source: Robert Damelio, The Basics of Process Mapping
Cross Functional Map
• Illustrates workflow
• Shows an organization in it’s entirety
• Relationship between supplier and customer
Cross Functional Map
Source: Robert Damelio, The Basics of Process Mapping
Systems mappingIllustrates the functions in the system. What is it that you
actually do?
Very useful for Boards and Executive to have a high level understanding of the system
Allows for drilling down into aspects [departments] of the system
Swim lane design with ability to see duplications
Patient Journey Maps
• Patient’s perspective
• Providers see the system and its gaps different perspective
• More than one mapping tool can be utilized
Touch point mappingCustomer experience mapping
Customer intersect with the system
Where a patient values each point ofmedical intervention
www.entwinedigital.com
All maps will highlight
• Unnecessary :– delays – steps – handovers
• Duplication • Bottlenecks• Gaps
www.institute.nhs.uk
Quick ReviewCross functional maps - can be used when analyzing:cost reduction, time reduction, quality improvement defect reduction, measurement and evaluation, satisfaction, benchmarking
Relationship maps – Measurement System design and evaluation, Satisfaction questions
Fault Tree Analysis – emergency planning, contingency planning, system designing
Systems Mapping – system design, understanding the functions of a system, clarifying a system
Patient journey mapping – understanding a system from the patient’s perspective
Touch point mapping – critical analysis of key access points into the system
Quick Review - continued
Process mapping is a means not an end.
Not all tools are appropriate
ASK QUESTIONS!!!
Question, Question, Question.
Ask questions, dig deep to understand a process, don’t assume.
ExerciseIn your groups design the process for the output given to
you.
Who is your audience? Do you have all of the information required to complete the task?
The process should be clear to follow and the result must allow for exact replication.
SourcesConcept mapping: an introduction to structuredConceptualization in health care., William Trochim, Mary KaneInt J Qual Health Care 17 (3): 187-191. 2005.
Process Mapping: one of three, New, special quality tools for management, quality and all other professionals . Ronald P AnjardMicroelectron Reliab., Vol. 36, No. 2 223-225, 1996
Process management tasks: a conceptual and practical view, Rafael Paim, Heitor Mansur Caulliraux, Rodolfo Cardoso, Business Process Management Journal, Vol. 14 No 5 2008
Damelio, Robert. The Basics of Process Mapping. Productivity Press. © 1996.
Avedis, Donabedian, Evaluating the Quality of Medical Care, Milbank QuarterlyVolume 83, Issue 4, pages 691–729, December 2005
http://www.processexcellencenetwork.com/
https://idc.northernhealth.ca/qt/System%20Maps/Forms/AllItems.aspx