Workflow analysis is of significant importance to modern nursing agencies. Proper workflow analysis establishes the workflow sequences that boost the adequate utilization of organizational resources and eradicate insignificant processes of the system if they are present. The standard tool that therapeutic agencies use to evaluate their workflow processes is the flowchart. Most importantly, the flowchart helps in assessing the notable activities that are in need of improvement, in order to improve the entire organizational process (McGonigle & Mastrian, 2015). Therefore, a flowchart depicts a pictorial representation of different processes and steps in successive order. The current paper outlines a patient’s appointment flowchart in a clinic and analyzes its processes with the aim of maximizing the healthcare utility. It also proposes the necessary adjustments in patient’s appointment processes for overall improvement.
The workflow process for a patient’s appointment starts with the patient contacting the clinic. To begin with, the patient reaches the healthcare center for a consultation through a telephone call. The clinical policy is that a patient must make an appointment by going to the clinic and contacting the help desk. At the help desk, the receptionist then uses an electronic health record (EHR) system to fill in the patient’s demographic data, such as age, year of birth, home address, social security number, emergency phone number, and the name of the insurance provider (McGonigle & Mastrian, 2015). The receptionist makes sure that this critical data is saved to the statistical and insurance module of the clinic’s e-registration system.
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A Flowchart of a Patient’s Visit to a Clinic
New patients are sent to a waiting room for a 30-minute appointment. Since patients’ names and contacts are not reflected in the clinic’s health electronic system, the staff is provided with a patient identification (PID) number that is different from other patients. However, for the returning patient, the receptionist requests his/her PID and schedules him/her for a brief 10-minute appointment (Huser, Rasmussen, Oberg, & Starren, 2011). The clinic’s file clerk then creates a new paper chart and prints out the patient’s registration information. The registration details of the new and the returning patients are saved on the system’s chart. This step is important because the file clerk will only have to find the file record of the returning patient from the storage room, update the demographic data and then put the file record in the waiting charts bin.
On the day that the patient returns for the appointment, the receptionist runs his/her social security number and confirms that the patient’s name on the system matches with the name appearing on the patient’s card. Thereafter, the clerk validates and updates the patient’s demographic information in the EHR system (McGonigle & Mastrian, 2015). The patient is given a medical form to fill in all the details on his/her past therapeutic history, present health problems, and the key reasons for the present clinical visit. The form is to be filled and completed, while the patient waits to be taken to a medical exam room. Meanwhile, the receptionist notifies the nurse that the patient has returned. When the nurse is available, the patient is sent to the medical exam room.
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The doctor’s physical exam, medical laboratory, radiology test, and patient’s release are the next imperative processes of the clinical workflow. When the patient arrives at the exam room, the nurse scrutinizes the patient’s filled form, records the patient’s critical symptoms, and inputs the patient’s vital information into the EHR system. Thereafter, the doctor files the patient’s analysis and documents orders, such as prescriptions, lab, and radiology in the chart form after the completion of the medical exam. The doctor writes a medication order and gives a written drug prescription to the patient, prior to abandoning the room. Therefore, the doctor updates the medical chart to specify that the chart is inclusive of orders (Koppel & Kreda, 2010). The patient then returns to the clinic’s help desk and makes an appointment, if the return visit is necessary. Thus, the nurse carries out the doctor’s orders, including the preparation of lab tests, radiology tests, and providing the patient with test results because it is a clinical policy.
Upon the completion of the lab and radiology tests, their results are being sent to the clinic printer. These results are entered into the charts for further medical evaluation. The patient, whose medical analysis reveals any strange lab and radiology test results, is reported back to the doctor. Nonetheless, the patients whose lab and radiology test results are positive, are sent the text message, indicating that their medical results are within the normal range. Since the patients require their medical prescription to be refilled, the receptionist writes an order note and delivers it to the nurse station in the infirmary (Koppel & Kreda, 2010). Afterward, the nurse puts this order note in the chart and keeps it in a special bin, so that the doctor can review it. The doctor puts the chart in the medical bin, following the writing of the refill prescription, and thereafter, the nurse contacts the patient and informs him to go to the pharmacy, in order to receive medication.
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The Areas of Waste in the Patient’s Visit to a Clinic Workflow
The patients criticize the workflow process of filling out and reviewing medical forms and updating their health information in the waiting area when they reach the health center for their appointment with the physician. Since paper charts are manual files, they sometimes get lost, and it takes a while for the clinic’s file clerk to retrieve them (Koppel & Kreda, 2010). In addition, many nurses have issues with doctors’ handwriting, as it may be hard to read and, therefore, difficult to interpret. Because of this issue, the nurses find themselves making minor mistakes while expounding the medical orders from doctors.
At the same time, nurses utilize a substantial amount of time to arrange the printed lab test results and radiology reports and put them in patients’ charts so that the doctor can analyze them. In addressing this issue, it would make the work easier to have the entire lab test results and radiology reports sorted by a software system, instead of using manual methods (McGonigle & Mastrian, 2015). The nurses also dedicate more time to determining the patient’s medicine allergies and establishing the necessary prescriptions on the physician’s medication orders. In fact, the nurses utilize search engine applications, such as Google and Bing, to find out the drug details. Since not all returning patients are careful enough, some misplace their PID cards and prescription forms that were filed at the front desk. Due to this issue, the nurses consume a substantial amount of time contacting the pharmacy department, in order to approve them.
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Recommended Changes for the Process Improvement
The process of arranging the printed lab test results and radiology reports and keeping them in the patient’s charts for the doctor to analyze them would be less challenging if these reports would be sorted out before the day of the patient’s appointment. This change will create ample time for nurses to place the printed lab test results and radiology reports orderly before the patient visits the clinic (Huser et al., 2011). The hospital should provide extra patient education on their ailment conditions; for instance, the infirmary must update its website section of disease prevention to create the patient’s awareness of the disease’s risk factors and ways of preventing them. Placing all the key metrics in the clinical paper chart is difficult, and, therefore, the system should be modified to allow health metrics, such as BMI, the blood pressure level, and lab data, and weight to be merged together in the paper chart.
Summary and Conclusion
The awareness of the flow of activity for clinical workflow is important because it evaluates the medical work processes that require modifications and establishes the useful decision points for abating the identified wastes. Notably, the primary figures, involved in a patient’s visit to a clinic workflow, are the receptionist, the clinic’s file clerk, the nurses, and the doctor. The decisions on the patient’s drug prescription are determined by the doctor, while the nurses execute the medical orders on lab and radiology tests. The total number of patients visiting the clinic and the total number of new patients, reporting to the infirmary, are the significant metrics that determine the productivity of the clinic’s workflow.