Process Mapping

Objective of this session

• Discussion on What is Process & Process Mapping
• Why Process Mapping is important
• How to Map the Process
• Wastes in Hospital (MUDAS)
• Exercise
QUALITY IS DOING
THE RIGHT THINGS
IN A
RIGHT WAY
FIRST TIME &
EVERY TIME.
WHAT IS A PROCESS

A process is a set of interrelated or interacting

activities which transforms inputs into outputs

A process is defined as “a series of steps which

convert one or more inputs into one or more
outputs.”
What is a process map ?
• Graphical representation of the series of steps of a process
• A pictorial representation of the sequence of actions that
comprise a process.
• It traces the flow of physical product and information through
the steps
• If there is no physical product, the map is used to document the
step-by-step activities involved in providing a service
Why process mapping ?
Why Process Mapping?
• Visually represents the work process
• Before you can improve a process, you must understand it.
• Provides a common understanding of the entire process and specific
roles and contributions of process participants.
• Identifies problem areas and opportunities for process improvement
• Process maps are a great problem solving tool
• Helps us determine what is the problem/what it is not
• You don’t learn to Process Map,
You Process Map to learn. (Dr.Myron Tribus)
Why Process Mapping
• Increase efficiency
• Eliminate non-value-added activities
• Reduce cycle time
• Expand service capabilities
• Simplify work flow
• Minimize dependencies
• Gain buy-in and organizational support for change
Looking at patient processes

• 30 - 70% of work doesn’t add value for patient

• up to 50% of process steps involve a ‘hand-off’, leading to
error, duplication or delay
• no one is accountable for the patient’s ‘end to end’
experience
• job roles tend to be narrow and fragmented
Symbols used to Process Map
• Start & End: An oval is used to show the materials, information or action (inputs) to start the
process or to show the results at the end (output) of the process.

• Activity: A box or rectangle is used to show a task or activity performed in the process.
Although multiple arrows may come into each box, usually only one arrow leaves each box.

• Decision: A diamond shows those points in the process where a yes/no question is being asked
or a decision is required.
Important Points
• Process Map what is, not what you would like the process to be.
• Process Mapping is dynamic. Use Post-it notes, dry erase
markers, pencil, etc.
• All Process Maps must have start and stop points.
Compiling a Process Map

Name of the person

completing task
+
verb

Who does what and when?

Process Bottlenecks

The step takes a significant time, and slows the whole

process down.
Functional Bottleneck
VALUE / NON-VALUE ADDING STEPS

Value adding
 The activity transforms the patient and moves them towards the next defined outcome
 The activity is something that the patient cares about

Non-value adding
 Do not serve any purpose (aim to remove these)

Necessary non-value adding

 Do not directly benefit patient but are necessary
e.g. completion of forms, logging patient details onto systems, numerous checks of details
Value-added Task
• It is done right the first time with no waste or rework.

• It is value-added or it is waste (non-value added)

WASTE IS A SENSITIVE ISSUE
• Its critical to eliminate “waste”

• Its also critical to recognise that the non value adding activities
may have been a core part of someone job for many years

• It’s the activities that are non value adding not the person
Wastes in Hospitals (MUDAS)

1. confusion
2. Motion/conveyance.
3. waiting
4. over processing
5. inventory.
6. defects
7. over production.
Wastes in Hospitals (MUDAS)
1. Confusion:
• Nurses spend 65% of their time looking for things they could
not find, clarifying unclear instructions and doing redundant
paperwork. (Jimmerson et al. 2005). Confusion includes questions
like:

• What do I do with this requisition?

• What does this order mean?
• Where do I have to store this item?
Wastes in Hospitals (MUDAS)
2. Motion/conveyance:
• Physical movement required to get a simple task done and to
move people from place to place.
• Redundant reaching for items.
• Walking to another location only to return to the starting point.
• Conveyance of patients and materials from room to room or
department to department.
Wastes in Hospitals (MUDAS)
3. waiting:
• Waiting for :
• a procedure to be done,
• a medication to arrive,
• or a doctor’s order to be given.
Wastes in Hospitals (MUDAS)
4. over processing:
• Doing more activities than is necessary to complete a work.

• Multiple entries of patient’s demographic details during the

hospital visit.
Wastes in Hospitals (MUDAS)
5. Inventory:
• Stored supply that are:
• Obsolete.
• Duplicated.
• Unnecessary.
• Missed charges for items used.
 Wastes in Hospitals (MUDAS)
6. defects:
• Medication errors.
• Wrong site surgery.
• Leaving instruments in patient’s body.
• Wrong blood group errors.
• Bed sores.
• Incidence of fall from bed.
Wastes in Hospitals (MUDAS)
7. Over Production:
Doing more work than necessary.
Redundant Paper work. (Waste of patient time, possibility of error, )
Analysing the process map
 How many steps in your process?
 How many duplications?
 How many hand-offs?
 What is the approximate time of or between each step?
 Where are possible delays?
 Where are major bottlenecks?
 How many steps do not add value for patients?
 How many types of wastes are there between each step?
 Where are the problems for patients and staff?
Remember always aim to

Add value

Remove waste
Basic Process Redesign Techniques

• Eliminate non-value-added activities

• Eliminate duplicate activities
• Combine related activities
• Identify and remove waste at each step.
• Process in parallel
• Use decision-based, alternative process flow paths
Let us map a process
• Read the write up provided.
• Make a Process map of the process on the chart provided.
• Identify value adding and non value adding activities.
• Identify Process bottleneck.
• Identify wastes in the process.
• Design an alternative Process map.
Thank
you