DEWITT ARMY HOSPITAL Fort Belvoir, VA

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DEWITT ARMY HOSPITALFort Belvoir, VA
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OUTLINE

• Definition of Process Mapping
• Parts of Process Mapping
• Steps of Process Mapping
• Tools for Process Mapping
• Final Checking of Process Mapping
• Examples of Process Mapping
• How Process Mapping fits into the QSEs
• Common Mistakes in Process Mapping

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Process Mapping

• Is a graphical representation from start to
  finish.
• Flow chart

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TEMPLATEFlow Chart
Oval Show the input to start the process
Arrows show direction or the flow of the process
Box or Rectangle Show a task or activity
performed in the process
Diamond Shows where a Yes/No question is
asked or a decision is required
No
Yes
Make sure every feedback loop is closed, Every
path takes you either back or forward to another
step
Usually only one arrow out of an activity box.
If more than one arrow, you may need a decision
diamond.
Oval Show the output at the end of the process
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Tools for Process Mapping

• Pen and paper
• Post-It notes

• Software PowerPoint, Visio, etc.

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• Quality System Essentials
• Organization

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QUALITY SYSTEM ESSENTIAL Organization
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• Quality System Essentials
• Safety

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NEEDLESTICKOr other blood borne pathogen exposure
APPLY FIRST AID !!! OR REPORT TO ER IMMEDIATELY
ATTENDING MD
SUPERVISOR
NOTIFY SUPERVISOR Supervisor/ employee complete
the assigned forms What is the status of the
employee?

• SF 558 or progress notes. Give to injured
  employee
• Consent FORMS for HIV on both source injured
  employee
• Order draw lab tests STAT
• NEEDLE SOURCE (order set name)
• Tubes 1 red, 1 purple, 1 HIV
• Tests Rapid HIV-1 HIV Hepatitis B Surface AG
  Hepatitis C Antibody
• NEEDLE EMPLOYEE(order set name)
• Tubes 2 red, 1 purple, 1 HIV
• Tests HIV, Hepatitis B Surface Antibody,
  Hepatitis C Antibody CBC, CMP, HCG (female
  childbearing age)
• Decide on Tetanus shot
• If necessary, consult Community Health Nurse for
  psychological assistance

Patient, Contract , Student, Volunteer,
Visitor DA 4106
Military DA 4106 DD 689 FM 879
GS Civilian DA 4106, FM 879, DD 689 CA-1
CA-17 when applicable

• Ensure paperwork is properly filled out
• Forward Paperwork to designated area. REFER TO
  BACK PAGE.
• Report event to Infection Control

Report to ER for emergent care
Report to ER for emergent care
Report to ER for emergent care
Report to your respective Contract Representative
Office or Primary Provider for follow- up care
Report to Occupational Health within 72 hours of
injury for follow-up care, (bring SF 558) CA-1
should be submitted to Safety Manager within 5
workdays of the injury

• Decide on PEP (post exposure prophylaxis) therapy
• If YES, contact WRAMC Infectious Disease for
  follow up 202-782-1663

END
UPDATED 11-23-2004
Phone s ER (805-0518) Occ Health (805-0443)
Infection Control (805-0044) Safety Manager
(805-0157) Patient Safety (805-8048)CPAC
(703-704-2743)
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ACCIDENT/INJURY REPORTING
FIRST AID FIRST!!! IF UNCLEAR, REPORT TO ER
IMMEDIATELY
NOTIFY SUPERVISOR Supervisor/ employee complete
the assigned forms What is the status of the
employee?

• DD 689 Individual Sick Slip Form Supervisor
  will give a signed form to injured employee to
  seek medical attention at ETR or Occupational
  Health
• DA4106 Quality Assurance/Risk Management Form
  On duty injuries must be reported to Patient
  Safety
• MEDDAC FM 879 DeWitt Army Hospital Supervisor
  Mishap Report Required to be submitted to Safety
  Management Office within 5 days of
  injury/accident. DA 285-A-B-R may be substituted
  to report POV incidents for military.
• CA1 Federal Employees Notice of Traumatic
  Injury and Claim for Continuation of
  Pay/Compensation Supervisors are required to
  fill out form and bring it to Safety Management
  Office to be submitted to Department of Labor.
  Form is required to be submitted within 3 days of
  injury/accident.
• CA17 Duty Status Report Supervisor will fill
  out column A of form and give to injured employee
  if limited duty is applicable. Employee will
  provide form to provider and return to
  supervisor.

SUPERVISOR
Military DA 4106 DD 689 FM 879 (Both On and Off
Duty accidents must be reported)
GS/WG Civilian DA 4106, FM 879, DD 689
CA-1 CA-17 when applicable
Contract , Student, Volunteer, Visitor DA 4106

• Ensure paperwork is properly filled out
• Forward Paperwork to designated area. REFER TO
  BACK PAGE.
• Report event to Safety Management Office at
  703-805-0157

Report to ETR for emergent care and OH for first
aid (DD 689 required)
Report to ETR for emergent care and OH for first
aid (DD 689 required)
Report to ETR for emergent care
Report to your respective Contract Representative
Office or Primary Provider for follow- up care
Report to Occupational Health within 72 hours of
injury for follow-up care and bring DD 689 and
ETR Report (SF558) if seen at DACH ETR. For
GS/WG civilians, medical documentation is
required.
UPDATED 02-04-2005
END
Phone s Safety Manager (805-0157) Occupational
Health (805-0443) Infection Control (805-0044)
Patient Safety (805-8048)CPAC (703-704-2743)
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• Quality System Essentials
• Occurrence Management

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• QSE
• Purchasing and Inventory
• Process Control

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QUALITY SYSTEM ESSENTIALSPURCHASING AND
INVENTORY
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• QSE Process Improvement

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Urine Collection Process in the Outpatient
Phlebotomy Area
Ship to reference lab?
Start
Print Verify Labels
Patient Arrive
Yes
No
Label samples
Specimen transport to UA section
Log in CHCS
Patient Collect Sample
Met Requirements ?
Yes
Patient turn in sample
Transport to Shipping dept
Give instructions to patient
No
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INPUT
STEPS
OUTPUT (Adjustable, Specifications?)
(Valuable, Measurable?)

BEGIN
END
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IMPROVE CUSTOMER SERVICE IN THE PHLEBOTOMY ROOM
INPUT PROCESS
OUTPUT (Adjustable, Specs?)
(Valuable,
Measurable?)
Patient arrive
Log in CHCS
Verify Labels
Collect samples
Transport to lab
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Example of Measurable Output CUSTOMER SERVICE (
Patient Satisfaction Survey 2007)
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Example of Measurable Output CUSTOMER SERVICE
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QUALITY SYSTEM ESSENTIALSASSESSMENTS
PHLEBOTOMY WAITING TIME
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QUALITY SYSTEM ESSENTIALSASSESSMENTS 2007
PATIENT RECALL (Threshold lt 1)
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Example of Measurable OUTPUT
peers
Your lab
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Steps of Process Mapping

• First identify the PROCESS
• Provide OUTPUT variables for each step before
  the INPUT variables
• OUTPUT Valuable or measurable
• INPUT Controllable and enter specifications
• P and 5 M (People, Machine, Materials, Method,
  Mother Nature, Measure)

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Improve Customer Service In The Phlebotomy Room
INPUT PROCESS
OUTPUT (Adjustable, Specs?)
(Valuable,
Measurable?)
Patient arrive
Log in CHCS
Verify Labels
Collect samples
Transport to lab
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Finalizing the Process Mapping

• Review the process, by observing or asking the
  operator
• Are the operators following the process as
  charted?
• Do you have a consensus?
• Do you need to add or remove steps?

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Process Mapping Mistakes

• Map is too detailed, too much information and
  does not emphasize the importance.

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Process Mapping Mistakes

• Process is not focused on your main goal i.e.
  create value for your customer (customer
  satisfaction)
• Map the process without showing how the results
  will be measured

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QUESTIONS