Process Mapping

Outline
Processes Intro to process mapping Why process mapping?

Process Attributes Design emphasis Process FMEA prerequisite Complexity or difficulty

Who manages the process? Caveats More on process mapping

A definition of process
A collection of interrelated work tasks, Initiated in response to an event Achieving a specific result for the customer and other stakeholders of the process.

Source: Sharp and Mc Dermott Workflow Modeling 2001

Processes
Customer = recipient or beneficiary of result produced by the process. Interrelated = the completion of one task initiates the next task in the process. A triggering event, which involves the customer, marks the start of the process. Achieving the specific result for the customer marks the end of the process.

Processes are supported by enablers

Workflow design Information technology Motivation and measurement Human resources Policies and rules Facilities

Sub-processes
A process can be made up of processes, often called sub-processes Defining the process and its boundaries depends on your perspective The event that initiates a process could be part of a larger process.

Process vs. Task

Everyday usage: no universal distinction For our purposes:

Processes involve more than one person, coordinated effort is required. Tasks involve one person

Theory of ones: Every process must be justified -why cant the result be achieved in one activity, by one person, at one time?
Source: Harrington, Business Process Improvement Workbook

Process maps
A graphical presentation that document the tasks and other aspects of processes Familiar version know as flow charting Numerous formats or approaches exist 2 versions of a process map are common: As-is: the current state of the process To-be: the goal state of the process Widely used. Not widely researched.

Process Mapping Basics

Arrows and Icons Lots of approaches Best for Medicine?
Patient General Practitioner Radiology
appt Physical Physical
Mammo gram Mammo gram consult consult consult consult

appt

Recv

consult

appt

Develop

send Sched/ orders Sched/ orders

Surgeon
Hospital Pathology Radiological Oncologist Medical Oncologist Physical therapist

appt

Consult

Error #1

Consult

Consult

Likely results of process mapping

Increased understanding of process, Increase consensus about the process, Increased visibility into the process.
Those who assume they know the process, without having mapped it, will probably find surprises when they map the process.

Dimensions of process mapping approaches

Level of detail Multi layered (Nested or Hierarchical?) Multiple types of flows Shows hand-offs (organizational structure) Icons Logical operators Flow time User support information

Identifying risks and hazards:

Caveats
In some cases, it is easier for customers to define the business process because they are the only one who see it all. (Sharp & McDermott) From customers perspective, the process may often involve multiple sub-processes. Optimal sub-processes will not result in optimal customer processes

Identifying risks and hazards:

Caveats
Optimization of sub-processes usually leads to suboptimization of processes* Sub-processes should be designed to contribute to global optimality. Carefully crafted sub-optimal (inefficient) sub-processes will be required for optimal customer outcomes
*Goldratt, The Goal, North River Press 1984

Process Mapping

Flowchart

Books on the subject:

Galloway, Dianne (1994) Mapping Work Processes, Milwaukee, Wisconsin: ASQ Quality Press. Harrington, H. James, Esseling, Erik K. C., and Van Nimwegen, Harm (1997) Business Process Improvement Workbook New York: McGraw-Hill. Damelio, Robert (1996) The Basics of Process Mapping, Portland, Oregon: Productivity Inc

Process Mapping:

Top-Down Process Map

Sub-processes are listed under each major process Minimal graphics could be text-only indenting sub-processes in an outline format
Books on the subject:
Wilson, Ray W. and Harsin, Paul (1998)

Process Mastering: How to Establish and Document the Best Known Way to Do a Job. Portland, Oregon:
Productivity Inc.

Process Mapping:

Top-Down Flow Chart

1
PSA test ordered
Subprocesses A. Order Written B. Entered in CPRS C. Received in lab

2
PSA test ordered
Subprocesses A. ID patient B. Select proper equip C. Draw blood D. Label

3
PSA test ordered
Subprocesses A. Review B. Centrifuge C. Verify calibration D. Run QC E. Run sample F. Report results G. Enter in CPRS

4
PSA test ordered
Subprocesses A. Report Received

5
PSA test ordered
Subprocesses A. Telephone B. Visit setup C. Result

DeRosier et al. joint commission Journal on Quality Improvement (28)5: 248-267.

Process Mapping

IDEF0

Pronounced eye-def zero Meaning boxes and arrows:

Control (information)

Input

FUNCTION NAME Process # Sub-process reference # Mechanism Call (tools & equipment)

Output

Source: http://www.itl.nist.gov/fipspubs/by-num.htm

Process Mapping

IDEF0

Nested or Hierarchical Diagrams

General

Detailed

Source: FIPS 183 available at http://www.itl.nist.gov/fipspubs/by-num.htm

Process Mapping

IDEF0
Micro-tubes

Web-based example
serum

Patient Sample

centrif uge sample 1

Bio-Hazard Waste

screen f or antibodies 2 A22

Antibodies negativ e

Reagents, etc. Bio-Hazard Waste ABO/RH

Test tubes Reagents, etc.

type sample ABO/RH 3

Antibodies Positive

A23

Patient History

Books on the subject: Federal Information Processing Standards (FIPS)183: Integration Definition for Function Modeling (IDEF0) http://www.itl.nist.gov/fipspubs/by-num.htm Hunt, Daniel V. (1996) Process Mapping: How to Reengineer Your Business Processes, New York: John Wiley & Sons.

identif y antibodies 4 A24 record results

Patient sample inf omration

Hemocare system

Process Mapping

Swimlanes
Flowchart superimposed on a grid Grid rows are organizations, departments, functions, or individuals Grid columns are chronological Team or joint activities indicated by boxes
Books on the subject: Sharp, Alec, and McDermott, Patrick (2001) Workflow Modeling: Tools for Process Improvement and Application Development, Boston: Artech House. Frazier, Jane C. (2001) Swimlane Process Mapping, Walnut Creek, CA: Frazier Technologies, Inc. (www.fraziertech.com) Jacka, J. Mike and Keller, Paulette J. (2001) Business Process Mapping: Improving Customer Satisfaction New York: John Wiley & Sons.

Process Mapping

Swimlanes: Susans Lumpectomy

Patient General Practitioner
appt appt Physical Physical appt
Mammo gram
Mammo gram consult consult consult consult

Recv
Develop send

consult

Radiology
Surgeon Hospital Pathology Radiological Oncologist Medical Oncologist Physical therapist

appt

Consult

Sched orders Sched orders

Error #1

Consult Consult

Process Mapping

Swimlanes: Susans Lumpectomy

Patient General Practitioner
Pre- Surgadmit ery
Request report Study report Consult Consult

treat

treat

Radiology
Surgeon Hospital Pathology Radiological Oncologist Medical Oncologist Physical therapist
Surgery Pre- Surgadmit ery Recv samp

Error #1 caught by patient

Analyze Type up send Plan treat Plan treat
Consult

Error #2

treat
Consult Consult

Error #2 caught By patient

treat

treat

Process Mapping

Value Stream Mapping

Rother, Mike and Shook, John (1999) Learning to See, Brookline, MA: Lean Enterprises Institute Inc. Tapping, Don, Shuker, Tom and Luyster, Tom (2002) Value Stream Management Productivity Press.

Process Mapping

Value Stream Mapping

Ordering and Scheduling info
As tasks are linked into one-piece flow they are combined on the map Production task & Inventory info Includes information On elapsed time

Process Mapping

Value Stream Mapping

24 icon set for lean manufacturing

Thank You! Questions?