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Baseline Assessments Swim Lane Diagrams

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Baseline Assessments Swim Lane Diagrams

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    1. Baseline Assessments / Swim Lane Diagrams Presented by: Helen C. Burch, MBA Managed Care Advisors, Inc.

    3. Process Assessment Research environment Interview stakeholders Collect documents Review data sources Verify information systems capabilities Document existing processes – swim lanes

    4. Assessment Criteria Core Measures Case Management Measures Data Measures

    5. Core Measures Accountability & Structure Regulatory Compliance Documentation Compliance Stakeholder Communication Clinical Services

    6. Accountability & Structure Philosophy, goals, objectives Organizational structure Committees

    7. Regulatory Compliance Reporting File maintenance Staff responsibilities

    8. Documentation Compliance Accuracy Completeness

    9. Civilian Communications Documents Correspondence Forms

    10. Clinical Services Installation services Community services

    11. Case Management Measures Information Systems Staffing Patient Protections Client Choice Identification & Assignment Client Disclosure Client Assessment Case Management Plan Requirements Complaints Discharge & Termination Return to Work

    12. Information Systems Systems integration Access Tools

    13. Staffing Job descriptions Credentials Caseloads Performance standards Physician expertise Staff development and management

    14. Patient Protections Confidentiality Security

    15. Client Choice Client rights Provider selection

    16. Identification & Assignment Selection Case Manager assignment Integration with third parties

    17. Client Disclosure Communications to client

    18. Client Assessment Evaluation

    19. Case Management Plan Plan development Review and updating Decision making

    20. Complaints Management and referral

    21. Discharge & Termination Case closure Discharge and termination

    22. Return to Work Vocational rehabilitation Modified and restricted duty Independent Medical Examinations (IMEs) Transition to work

    23. Data Measures - Metrics Program outcomes - frequency and cost Case Manager performance

    24. Business Process Mapping Swim Lane Diagram Technique for mapping organizational structure to processes Delineates ownership of all activities and processes within swim lanes

    25. Swim Lane Example

    26. Now What? Assimilate and record all information Review with stakeholders Identify leakage points Design and implement strategies for improvement Monitor progress

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