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Workflow Optimization Project. Martin’s Point Health Care Portland Health Center Julie Trimmer, Practice Director January 18, 2007. Share our Journey / Strategy What’s Inside our Toolbox. Objectives. Process Mapping Initiative – 2005 Opportunities Identified:

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workflow optimization project
Workflow Optimization Project

Martin’s Point Health Care

Portland Health Center

Julie Trimmer, Practice Director

January 18, 2007

Share our Journey / Strategy

What’s Inside our Toolbox

our transformation journey
Process Mapping Initiative – 2005

Opportunities Identified:

Communication: How we communicate with our patients. Multiple modes, many bottlenecks and rework loops.

Designing new processes

Electronic Health Record Implementation – 2005/2006

Preload (data/information extracted from paper records and loaded into EHR) - 2005

Scanning and Indexing – 2005

Full implementation – May 2006

New Clinic Planning – 2006/2007

Our Transformation Journey…..
mapping your process
Prepare a High Level Map

Minimum of 4 steps, maximum of 7 steps

Defines boundaries of the process to be mapped

High Level Example: Paper Medical Record Flow

Break down each high level into detailed steps:

Mapping Your Process

Patient Info generated on Paper

Medical Record Created, Formatted &/or Maintained

Patient care provided, patient info generated on paper

Request for Release of Records, pt. transfer, or deceased

Is Med Rec w/ pt info?

Pt Info signed?


Label pt information with name, DOB, Med Rec #

File per format/ P&P




Place in numerizor/loose filing bin for med rec to return

Identify the “clogs” or “pain points” that cause the most breakdowns

Return to staff for signature

what are we aiming for
Problem / Aim/ Theme Statement

Scope the project:

How do we get from a “boil the ocean” to a precise target/goal?

From / To format (from x to y by z)

Decrease cycle time from 72 hrs to 48 hrs by 12/31/06

SMART goals (Specific, Measurable, Action Oriented, Realistic, Time-bound) – example

High Level Goal: Eat Healthier Food in 2007

SMART Goal: Eat 5 servings of Fruits and Vegetables each day.


Affinity Diagram

Takes groups of data (brainstorming) and organizes to get consensus on the theme/issue.

What Are We Aiming For?
summary of affinity diagram
Summary of Affinity Diagram

Agree on issue – what prevents us from getting there?

Our Project Results:

Post It Notes- each team member answers – 1 complete sentence per note

Answers are grouped, titled, and voted by team

what do our customers require
Translate broad requirements to details that can be measured:

Example: Excellent Patient Service

What does that mean? (Knowledgeable Reps, Short wait)

How?(Rep accuracy, time on hold, time in waiting area)


Voice of the Customer

Takes the voice of the customer or customer needs and uses that information to produce design or improvements that meets those needs.

What Do Our Customers Require?
requirements specifications
Project Example:

Staff Needs:

What: reduce rework, adequate training, defined and consistent workflows

How: standard operating procedures, matching roles and responsibilities with skills and knowledge, training forums, reference guides/tools

Requirements / Specifications
how will we know if we made a difference
Measurement Systems / Data Collection

Primary Metrics (results measures)

Secondary Metrics (process measures)




Tally Sheets (reliability)

How Will We Know If We Made a Difference?
data collection
Data Collection

Provide an explanation of why/what/how to track

  • Reliability Factors:
  • Provide a sample tally sheet as a guide
  • Walk through with staff how to record the data
how do we manage the people side of change
Change Management

Success at change can be directly impacted by effective change management.

How do you take a group or individual from the current state to the future state?


ADKAR: 5 Building blocks for successful change:

Awareness – where change begins, (WIIFM)

Desire – personal choice to support the change

Knowledge – understanding of HOW to change

Ability – achievement of the desired change in performance or behavior

Reinforcement – any action or event that sustains the change

Stakeholder Analysis: Identifies people or group inside and outside the organization who are impacted by the project or can influence it:

Gage level of commitment and develop communication strategy and ideas to relieve the resistance to change.

How Do We Manage the People Side of Change?
change assessment
Change Assessment

ADKAR – Project Results (Providers, Clinical Support, Admin support)

Stakeholders - Sample

Action Plan to fill the gap

who does what
Process Mapping

Roles and Responsibilities Matrix

Functional Job Analysis:



Training and Education required

Upon what instructions (knowledge, skill, ability, & performance standards)

To accomplish what organizational outcome or result?

For each task: verify task in question is performed, how frequently the task is performed, and how many minutes to complete one instance of the task.

Getting the right work to the right people


Matrix Analysis

Identifies overlap in work performance in identifying opportunities to reassign task responsibilities.

Functional and skill ratings offers guidance as to who should perform tasks given the complexity of task performance.

Who Does What?
our roles responsibilities matrix
Our Roles & Responsibilities Matrix

Project Sample:

Sort for overlap/duplicate tasks

Staff/Skill assessment comparison

how and who to contact
Julie Trimmer, Practice Director:


Black Belt, EHR Implementation

Lauren Rice, Project Manager:


Green Belt & Coordinator for Practice Projects

Michelle Wyman, Manager of Organizational Effectiveness:


Certified in Change Management

Suellen Shaw, Black Belt: 253-6288;

Project Leader: Workflow Optimization Project

Joanne O’Neil Lafferty, Manager Health Professional Development: 253-6316;

Learning Collaboratives (Practice Redesign; Clinical Microsystems; Physician Leadership)

How and Who to Contact