Developing New Workflows in Response to a Crisis

Documenting workflows, or process mapping, is a great way to capture the current need for daily and sometimes hourly changes practices are experiencing with the recent COVID-19 crisis. The advantage of mapping a process as a group of inter-related steps is that you document the process from multiple perspectives.

Example:

• Patient sent message via portal regarding recent medication change issue and to confirm upcoming visit with provider in 3 days.
• Nurse triages portal message and alerts provider
• Provider messages patient with instructions regarding the change of medication and requests patient call to schedule a follow-up telehealth visit in 2 weeks in place of the scheduled appointment in 3 days.

Outcome:

• Patient made requested med changes and scheduled virtual visit in 2 weeks
• The visit in 3 days was not canceled
• Patient was sent a reminder text for the appointment that should have been canceled and sends another message via the portal seeking clarification

How to Improve Outcome with Process Mapping:

• When telehealth visits were implemented to temporarily replace in-person visits for preventive and routine appointments, process mapping could have identified the need to shut off auto call reminders for all booked in-person visits or to ensure auto call reminders are updated to reflect current telehealth procedure.  This could have resulted in less patient confusion and worry and lessened the in-bound communication to the triage nurse.

With daily, if not hourly changes, how are practices sharing ever-changing process maps?

Some practices send date/time stamped picture of refined process maps via text to all staff. When a new process is first developed and a practice plans to implement rapidly, we recommend you meet with all members of your practice staff to review the workflow, discuss what change you are addressing and to invite input to promote an active and responsive feedback loop. 

Process mapping can capture the unique gaps of care and communications with patients during time of change, which also allows all staff to have a voice and communicate gaps and needed workflow changes.  Remember the importance of multiple perspectives when changing processes.

The value of the tool is that it can clearly outline and manage changes that allows staff to visually see in real time what changes are happening.

HealthTeamWorks Solutions Center offers a guide on process mapping that is available under the "Related Resources" for this blog.