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Use a flowchart

A flowchart is a tool you can use to map out the steps of any process that takes place in your organization. Whether it is the process by which a patient is checked-in at the front desk or has her blood drawn, it can be viewed as a series of separate steps. Once broken down in a flowchart, it is easier for you to spot potential places where something might go wrong — a lab result that may not be communicated back to the patient, the wrong electronic health record on a physician's screen, or other small misstep that could result in patient harm.

1. Chart your process
  • Gather people from different areas involved in the process.
  • Agree on the first and last steps of the process. Then map out the steps in between using the techniques below. This will likely take multiple tries. Map out the process you have, not the process you wish you had.
  • Pick someone to act as a scribe. Use a large sheet of paper and marker or sticky notes and marker.
  • Use shapes to show steps in the process or decisions to make and arrows to show the direction of flow. The first time you make a flowchart, try an everyday non-healthcare process such as making a cup of coffee or buying cereal. Then try a healthcare process. See examples below.
2: Discuss the steps in the flowchart

Look at the flowchart for the healthcare process you chose. For each step, ask members of the group to check all that apply:

    • Works well
    • Not a problem
    • Small problem
    • Real problem
    • Totally broken
    • Cannot rate
    • We’re working on it
    • Source of patient complaint
3: Identify a process step to improve

Pick a part of the process to start making small changes to improve safety. Identify a step to improve. Consider each step and look for:

    • Bottlenecks and other sources of delay
    • Rework due to errors
    • Role ambiguity
    • Duplicated efforts
    • Unnecessary steps
    • Sources of waste
    • Variation
    • Hand-offs

Adapted from: Practice Facilitation Handbook. Content last reviewed January 2017. Agency for Healthcare Research and Quality, Rockville, MD.

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