1. Paul King V. U. School of Engineering
Flowcharting
Paul King
V. U. School of Engineering

2. Overview This Lecture will overview flowcharting of processes.
Elementary to detailed charting will be covered.

3. Why Flowchart??? Document the process. Allow study of roadblocks
Allow display of timing & conditionals.
Provide a communication tool.

4. Examples to follow: Hinge Manufacture Hypertension Clinic #1
The ideal?
ABET Diagram
Breast Cancer Clinic.

6. Hypertension Clinic - Flow Study #1
Patient enters, signs in, waits in waiting room until called
Patient goes to weigh-in room, weight & pulse rate taken, medications reviewed (RN).
Patient goes to new waiting room.
Patient is sent to room, put on bed, lights out, 2 minute wait, BP taken (RN).
Patient to waiting room
Patient to clinic room ...

7. Hypertension Clinic - Flow Study #1, Continued
Patient interviewed by MD or Resident/MD, BP taken?
Patient medications reviewed, lifestyle, needs.
Patient discharged & rescheduled and tests ordered if necessary or admitted...

8. Flowchart: Hypertension Clinic # 1
Delay Delay Delay Delay
Overall waiting time: 14-70
Actual patient interaction 7

9. Discussion Using delay symbols for patient wait states stresses delays
Each delay is in fact a wait for event, simplified here.
Waiting times may be expressed as here, or as color bars for easy identification of outlier cases
Actual overall waiting times have ranged up to 100 minutes

10. Flowchart: Hypertension Clinic #2
Delay Delay Delay
Overall waiting time: 9-50
Actual patient interaction 7

11. Discussion Using delay symbols for patient wait states stresses delays
Overall delay time has dropped.
Delay 2 & 3 may be combined...
Actual overall waiting times have decreased

12. Future Clinic Structure?
Time in-out 7-20

13. Discussion
While the chart is more complicated, the process is easier for most patients.
MD time is utilized for “needy” patients.
RN time is used for less needy.
Many patients will be status quo.
This is approximately the dentist office model..

14. Determine educational
The Two Loops of EC2000
Determine educational
objectives
Determine Outcomes
Required to Achieve
Objectives
Evaluate/Assess
Determine How
Outcomes will be
Achieved
Input from
Constituencies
Formal Instruction
Student Activities
Determine How
Outcomes will be
Assessed
Establish Indicators
that Objectives are
Being Achieved

15. Discussion
Flowcharting in this fashion is far more powerful than the written text.
Flowcharts can be used to make a point of interactions between several factors.

16. Typical Undergraduate Flowcharting Project
Breast center, 50 patients a day
Categorize (normal v next step)
Interview a subset
Observe interactions and flow over three months
Walk through the problem.
Interview staff.
Flowchart data, analyze data, recommend changes.

17. PATIENT FLOW ANALYSIS OF VANDERBILT BREAST CENTER
Michelle E. Kandcer, B.S.
Doris Quinn, PhD, Advisor

18. PROJECT DEFINITION
The goal of this project is to assess and to improve the patient flow process in Vanderbilt’s Breast Cancer Center. Patient responses will be of significant consideration.

19. OBJECTIVES
To create a flowchart in (Micrografx Flow-Charter 7.0) that will describe the current patient flow process.
To highlight weaknesses of the process.
To emphasize (on the flowchart) patients’ feelings regarding the process.
To make suggestions as to how to improve the current process.

20. SIGNIFICANCE
The American Cancer Society estimates that 178,700 women will be diagnosed with breast cancer this year alone and that 3,900 of these women will be from Tennessee. Furthermore, another 43,500 women will die because of this disease. *
Currently, more than 50 women per day utilize services provided by the Cancer Center.

21. WORK COMPLETED Flow of Pre -Registration

22. WORK COMPLETED Flow of Registration

23. WORK COMPLETED Process Flow for those Needing Mammograms

24. WORK COMPLETED Process Flow for those Needing Mammograms (continued)

25. WORK COMPLETED Process Flow for those Not Needing Mammograms

26. WORK COMPLETED Process Flow for those Not Needing Mammograms (continued)

29. Summary
Flowcharting works!.
Flowcharting is a useful tool.