1. Cause and effect diagram
Process
Staff
No standard rooming process due to physician preference variations
MAs support opening procedures and end of day cash reconciliation process with reception staff
Walk-in visits require MA to leave current task
Search for supplies in exam and stock rooms
No established supply par levels
Wasted motion going to printer or picking up medications, educational material or supplies
Staff who arrive after 7:45 miss daily huddle
High turnover increases inefficiency and training demands
Disorganized medical supplies
No standard process for ordering needed supplies
Problem statement:
Practice workflow inefficiencies decrease value-added time spent with patients
Patients may not arrive at scheduled appointment time
Not enough physician documentation time during clinic session to complete for all patients
Patients may omit important health information during visit
Cannot place lab orders for new patients until they have been established at the practice
Physician schedules are configured without consideration of patient complexity
Patient visit documentation requires clicking to multiple tabs
First patients of morning and afternoon sessions roomed late because of pre-clinic huddle
Physician prints, staples and reviews after visit summary
Some patients may not want to disclose the reason for the visit over the phone
Documentation
Patient
Red text: causes of inefficiency that can be controlled and improved.
Black text: influences that are more difficult to control.
Source: AMA. Practice transformation series: starting lean healthcare
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