Clinical Workflow Analysis, Process Redesign, and Quality Improvement

2016 ◽  
pp. 135-161 ◽  
Author(s):  
Mustafa Ozkaynak ◽  
Kim M. Unertl ◽  
Sharon A. Johnson ◽  
Juliana J. Brixey ◽  
Saira N. Haque
Keyword(s):  
Quality Improvement ◽  
Clinical Workflow ◽  
Process Redesign ◽  
Workflow Analysis ◽  
Analysis Process

scholarly journals Fourteen years of quality improvement education in healthcare: a utilisation-focused evaluation using concept mapping

2019 ◽  
Vol 8 (4) ◽  
pp. e000795 ◽  
Author(s):  
Frida Smith ◽  
Patrik Alexandersson ◽  
Bo Bergman ◽  
Lisa Vaughn ◽  
Andreas Hellström
Keyword(s):  
Quality Improvement ◽  
Concept Mapping ◽  
Mixed Method ◽  
Healthcare Professionals ◽  
Organisational Performance ◽  
Healthcare Staff ◽  
Long Term Outcomes ◽  
Analysis Process ◽  
Kirkpatrick Model

BackgroundThe need for training in quality improvement for healthcare staff is well acknowledged, but long-term outcomes of such training are hard to evaluate. Behaviour change, improved organisational performance and results are sought for, but these variables are complex, multifactorial and difficult to assess.AimThe purpose of this article is to explore the personal and organisational outcomes identified by participants over 14 years of university-led QI courses for healthcare professionals.MethodInspired by the Kirkpatrick model for evaluation, we used concept mapping, a structured mixed method that allows for richness of data to be captured and visualised by inviting stakeholders throughout the process. In total, 331 previous course participants were included in the study by responding to two prompts, and 19 stakeholders taking part in the analysis process by doing the sorting.ResultTwo maps, one for personal outcomes and one for organisational outcomes, show clusters of the responses from previous course participants and how the outcomes relate to each other in meta-clusters. Both maps show possible long-term outcomes described by the previous course participants.ConclusionThe results of this study indicate that it is possible that training in quality improvement with a strong experiential pedagogical approach fosters a long-term improvement capability for the course participants and, even more important, a long-term improvement capability (and increased improvement skill) in their respective organisations.

Process improvement for professionalizing non-profit organizations: BPM approach

2016 ◽  
Vol 22 (3) ◽  
pp. 634-658 ◽  
Author(s):  
Carolina Resende Haddad ◽  
Diego Hernando Florez Ayala ◽  
Mauricio Uriona Maldonado ◽  
Fernando Antônio Forcellini ◽  
Álvaro Guillermo Rojas Lezana
Keyword(s):  
Process Improvement ◽  
Process Analysis ◽  
Management Tool ◽  
Content Type ◽  
Non Profit ◽  
Process Redesign ◽  
Analysis Process ◽  
Process Implementation ◽  
Original Case ◽  
Non Profit Organizations

Purpose – The purpose of this paper is to present a proposal for process improvement at the Department of Social Responsibility of a Colombian process-based organization, called CAJASAN. The department has four main processes: Foniñez (children fund), Fosfec (unemployment fund), Project Management and International Cooperation and Network Management and Alliances. The objective of this paper is to suggest an improvement in these processes through BPM application. Design/methodology/approach – The authors followed the BPM method proposed by Dumas et al. (2013) for process improvement composed by process identification; process discovery; process analysis; process redesign; process implementation and process monitoring and controlling. The authors modeled the processes by using the software Bizagi®. Findings – The actual processes work in an independent way and with no communication. Moreover, the department experiences short-term problems solutions and process inefficiency. It was possible to suggest changes in three out of four processes. Practical implications – Implementing BPM in non-profit organizations (NPO) addresses many of the current management challenges faced by such organizations. NPO’s researchers and practitioners should take BPM as a potential way to help in professionalizing them. Originality/value – The authors bring an original case study about a Colombian NPO. As a process-oriented organization, the authors use BPM as a management tool to solve many challenges that the company faces nowadays.

scholarly journals An Evaluation of the Process and Quality Improvement Measures of the University of Virginia Cancer Center Tobacco Treatment Program

2020 ◽  
Vol 17 (13) ◽  
pp. 4707 ◽  
Author(s):  
Kara P. Wiseman ◽  
Lindsay Hauser ◽  
Connie Clark ◽  
Onyiyoza Odumosu ◽  
Neely Dahl ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Tobacco Use ◽  
Treatment Program ◽  
Disease Recurrence ◽  
Cancer Center ◽  
Second Primary ◽  
University Of Virginia ◽  
Clinical Workflow ◽  
Tobacco Treatment ◽  
The University

Tobacco use after a cancer diagnosis can increase risk of disease recurrence, increase the likelihood of a second primary cancer, and negatively impact treatment efficacy. The implementation of system-wide comprehensive tobacco cessation in the oncology setting has historically been low, with over half of cancer clinicians reporting that they do not treat or provide a referral to cessation resources. This quality improvement study evaluated the procedures for assessing and documenting tobacco use among cancer survivors and referring current smokers to cessation resources at the University of Virginia Cancer Center. Process mapping revealed 20 gaps across two major domains: electronic health record (EHR), and personnel barriers. The top identified priority was inconsistent documentation of tobacco use status as it impacted several downstream gaps. Eleven of the 20 gaps were deemed a high priority, and all were addressed during the implementation of the resulting Tobacco Treatment Program. Prioritized gaps were addressed using a combination of provider training, modifications to clinical workflow, and EHR modifications. Since implementation of solutions, the number of unique survivors receiving cessation treatment has increased from 284 survivors receiving cessation support during Year 1 of the initiative to 487 in Year 3. The resulting Tobacco Treatment Program provides a systematic, personalized, and sustainable comprehensive cessation program that optimizes the multifaceted workflow of the Cancer Center and has the potential to reduce tobacco use in a population most in need of cessation support.

scholarly journals Mapping outcomes in quality improvement and system design activities: the outcome identification loop and system impact model

2019 ◽  
Vol 8 (3) ◽  
pp. e000439
Author(s):  
Emmanuel Adeoluwa Akinluyi ◽  
Keith Ison ◽  
P John Clarkson
Keyword(s):  
Quality Improvement ◽  
System Analysis ◽  
Unintended Effects ◽  
Impact Model ◽  
Analysis Process ◽  
Design Activities ◽  
The Impact ◽  
Structured Approach ◽  
Impact Models ◽  
System Impact

BackgroundWhether explicit or implicit, models of value are fundamental in quality improvement (QI) initiatives. They embody the desirability of the impact of interventions—with either foresight or hindsight. Increasingly impact is articulated in terms of outcomes, which are often prescribed and sometimes inappropriate. Currently, there is little methodological guidance for deriving an appropriate set of outcomes for a given QI initiative. This paper describes a structured approach for identifying and mapping outcomes.Overall approachCentral to the approach presented here is the engagement of teams in the exploration of the system that is being designed into. This methodology has emerged from the analysis and abstraction of existing methods that define systems in terms of outcomes, stakeholders and their analogues. It is based on a sequence of questions that underpin these methods.Outcome elicitation toolsThe fundamental questions of outcome elicitation can be concatenated into a structured process, within the Outcome Identification Loop. This system-analysis process stimulates new insights that can be captured within a System Impact Model.The System Impact Model reconciles principles of intended cause/effect, with knowledge of unintended effects more typically emphasised by risk approaches. This system representation may be used to select sets of outcomes that signify the greatest impact on patients, staff and other stakeholders. It may also be used to identify potential QI interventions and to forecast their impact.Discussion and conclusionsThe Outcome Identification Loop has proven to be an effective tool for designing workshops and interviews that engage stakeholders, critically in the early stages of QI planning. By applying this process in different ways, existing knowledge is captured in System Impact Models and mobilised towards QI endeavours.

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