process maps
TRANSCRIPT
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Process MappingRebecca S. (Suzie) Miltner, PhD, RNAssociate Professor, School of Nursing
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Learning Objectives
Practice use of common and useful quality improvement tools:Process Maps
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Rationale for Process LiteracyCommon understanding, shared model
for an improvement team Identify parts of the system to measureHelps generate hypotheses for changeContext is critical
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Process Arrogance & Complex Systems“Exaggerated sense of knowing how
things work” – Ogrinc et al, 2012
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Describe an elephant
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Rationale for Process LiteracyCommon understanding, shared
model for an improvement team Identify parts of the system to measureHelps generate hypotheses for changeContext is critical
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Gathering Data to Understand the Problem: Suggested Steps
Appreciate culture and contextObserve processes Interview key personnelGet ideas down in writingFeedback from key stakeholdersCreate symbolic representation
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Understanding a ProcessCommon tools to help organize your
thoughts: Brainstorming and use of affinity diagrams Cause and effect diagrams (“fishbone” or
“Ishikawa”) Process flow maps (in Lean = “value stream
map”) Deployment flowchart Workflow (“spaghetti”) diagram
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Create a conceptual map of the process you use to get ready to come to work in the morning.
Use the labels provided.There are blanks ones for other
steps you may use.
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Skill Exercise
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What is your process?
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Alarm goes off
Drive to work
???
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Developing a Process MapWhy? Provides a common picture of a process
for the whole team. Helps identify which parts of the system
are important to measure. Helps generate ideas for change. (Define,
standardize or find areas for improvement in a process.)
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Visual representation of a process: IKEA style
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Developing a Process MapHow? Use symbols to represent steps in the
process Start with big picture and develop detail
later Need to have people who do the process
involved
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Process Map Symbols16
Rectangle: Denotes a step in the process or
instructions
Oval: Denotes the Start or Stop point in
the process
Diamond:Denotes a decision
point in the process
Arrow: Denotes directionTriangle:
Measurement point
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Simple Process Map
Preheat Oven
Carve and serve meat
Cook Meat
Prepare Turkey
Let meat rest
Done?
Yes
No
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Simple Process Map
Preheat Oven
Carve and serve meat
Cook Meat
Prepare Turkey
Let meat rest
Done?
Yes
NoIndicator 1: Time to preheat Indicator 2: Time at rest
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Step 1. Heat 2 TBSP oil in large wok or pan
Step 2. Add the vegetables in order of how long they will take to cook
Step 3. Add the cooked meat
Step 4. Crack two eggs into the middle stir to scramble them until they are almost cooked through
Step 5. Add the rice
Step 6. Stir swiftly around the wok until the rice is heated through
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Step 1. Heat 2 TBSP oil in large wok or pan
Step 2. Add the vegetables in order of how long they will take to cook
Step 3. Add the cooked meat
Step 4. Crack two eggs into the middle stir to scramble them until they are almost cooked through
Step 5. Add the rice
Step 6. Stir swiftly around the wok until the rice is heated through
“Looks good. But the six "easy" steps follow the less-easy and more messy - buy, wash, chop veggies; buy, cook rice; buy, chop, cook meat(s). The cooks in the back of the kitchen make the chef appear awesomely efficient.” (Kris Miltner)
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Developing a Process Map*When? When you need to clarify the process When you need to identify places to
measure key steps of the process. When you need to help others understand
the process. Procedure manuals?
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Not So Simple Process Map
Yes
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Current IAD Process Map
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Ideal IAD Process Map
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TipsBegin with the global aim statement
Where the process begins and ends Boundaries should be aligned with the aim
statement and improvement theme.Do not mix reality with wishful thinking.
Always map the CURRENT process Helps to understand where you can improve
the process
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Ideally!We haven’t done this
yet!
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TipsAsk what happens first, next, and then
what happens next. If DEPENDS, then pick the most common next
step and follow what happens after, and then go back to follow the other one.
Keep it simpleTurn the list of steps into a flow chart
using symbols
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Who is a puzzler?
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Breakout: Process MapWe are going to break out into 5 groups.One group is our puzzle experts.
They are going to create an ideal process map for a puzzle based on their knowledge of the process.
The other 4 groups will put a puzzle together.
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Breakout: Process MapPuzzle teams:Each team will get a set of puzzles.Put together the puzzle marked by a
circle on the back.Write down all the steps in the
process of solving the puzzle.Map the process on the
board/paper.
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Discussion: Process MapPuzzle experts will share the IDEAL
process map.Compare your team’s actual
process to the ideal. Are they the same? If not, where is the variation?
What did you learn about the process of putting a puzzle together?
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