Flow chart EHR Blood is drawn for INR by lab or home health or other Key: Circle = Start and Stop Box = activity Diamond = decision point Cylinder = EHR Result is sent to KUCIM Clinic along with notice of new meds and view of chart Result 1.5 to 3.5? EHR No Yes Provider adjusts does and sets f/u interval Who: MA & provider With: WbW Where: Clinic When: as needed What else: NA MA adjusts does and sets f/u interval Instructions given to pt

3. Ishikawa or fishbone diagram (Cause and effect diagram) Populate this by asking why 3 to 7 times Access to warfarin protocol Physician factors Factor 2 Factor 3 Factor 4 Factor 1 Patient factors Factor 2 Factor 3 Factor 4 Compliance with ___________ 4 M’s Methods, Machines, Materials, Manpower 4 P’s Place, Procedure, People, Policies 4 S’s Surroundings, Suppliers, Systems, Skills Correct provider receives INR Other personnel factors Factor 2 Factor 3 Factor 4 Factor 1 Clinic factors Factor 2 Factor 3 Factor 4

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