Process Mapping: What do we do and who does it

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• Process Mapping What do we do and who does it?
• Ronald Bialek - President and CEO
• Public Health Foundation
• Jack Moran - Senior Quality Advisor Public Health
  Foundation

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Flow Charting

• Flow charts provide a visual illustration, a
  picture of the steps the process undergoes to
  complete its assigned task 
• Flow charting is the first step we take in
  understanding a process
• Organized combination of shapes, lines, and text
• From this graphic picture we can see a process
  and the elements comprising it
• Shows how interactions occur
• Makes the invisible visible

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Mapping

• MapQuest
• Takes directions and converts them into a picture
• Shows various routes to a destination
• Shows communities you pass through to reach a
  destination
• Shows connecting roads
• Shows faster and slower routes
• Provides alternative routes

• Flow Chart
• Takes procedures and converts them into a visual
• Shows the routes inputs travel to become outputs
• Shows handoffs
• Shows connecting processes
• Highlights areas for improvement
• Triggers ideas to improve a process

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Flow Chart Benefits

• Creates a common vision
• Establishes the AS IS baseline Current State
• Baseline to measure improvements
• Identifies wasteful steps
• Uncovers variations
• Shows where improvements could be made
• Shows potential impacts of improvements
• Training tool

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Flow Chart People Benefits

• People involved in constructing a flow chart
  begin to
• Better understand the process
• Understand the process in the same terms
• Realize how the process and all the people
  involved, including them, fit into the overall
  process or business
• Identify areas for improving the process
• Become enthusiastic supporters to quality and
  process improvement

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Types of Flow Charts

• As Is current state - baseline
• Could Be improved state transition
• Should Be optimal state

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WIC Appointment
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Flow Charting Construction

• Clearly define the process boundaries to be
  studied
• Define the first and last steps start and end
  points
• Get the right people in the room
• Decide on the level of detail
• Complete the big picture first macro view
• Fill in the details micro view

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Flow Charting Construction Continued

• Gather information of how the process flows
• Experience
• Observation
• Conversation
• Interviews
• Research
• Clearly define each step in the process
• Be accurate and honest

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Flow Charting Steps

• Use the simplest symbols possible Post-Its
• Make sure every loop has an escape
• There is usually only one output arrow out of a
  process box. Otherwise, it may require a decision
  diamond.
• Trial process flow walk through it in real time
  
• Circulate the flowchart to other people involved
  in the process to get their comments
• Make changes if necessary
• Identify time lags and non-value-adding steps.

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Flow Chart Construction

• There is no one right way to develop a flowchart,
  but the following guidelines provide a general
  structure
• Start with a simple one-line description or title
  of the process being flowcharted , e.g., "How
  to..."
• Using a top-down hierarchy, start with an oval
  symbol named Start.
• Connect each successive action step in the
  logical sequence of events.
• Reference detailed information through
  annotations or connectors.
• Follow the process through to completion, denoted
  by an oval symbol named End

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Flow Chart Construction

• Use common symbols
• Use a form of Post-It Notes easier to rearrange
• Realize everyone is not doing it the same way
  there will be disagreements
• It will take multiple passes to get to the As
  Is State

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Flow Chart Symbols
Flow Lines
Manual Operation
Start/End Bookends
A
Connector
Data Base
Comment Collector
Activity Operation/Inspection
Wait/Delay
Decision
Display
Storage
Input/ Output Data
Manual Input
Transport
Document
Input
Preparation
Output
Forms
Unfamiliar/ Research
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Constructing a Flow Chart

• Asking questions is the key to flow charting a
  process. 
• For this process
• Who is the customer(s)?
• Who is the supplier(s) ?
• What is the first thing that happens?
• What is the next thing that happens?
• Where does the input(s) to the process come from?
  
• How does the input(s) get to the process?
• Where does the output(s) of this operation go?
• Is their anything else that must be done at this
  point?

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SIPOC

• A High level Process Map
• Helps in developing the As Is State
• Defines knowns from unknowns
• Shows gaps in QI Teams knowledge of a process
• Focuses data gathering activities

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Cautions

• In most processes
• Few people have seen the total process and fully
  understand the process
• Those that designed the process are no longer
  there
• Work is being done that adds no value to
  customers
• Work the customer needs isnt being done
• Rework is built into the process
• Inefficiencies are built into the process
• Workarounds have been developed that make the
  process appear to be working better than it
  really is

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Quality Improvement

• Analyze the As Is flow chart
• Look for Critical Processes
• Look for Handoffs
• Analyze with a Cause and Effect Diagram
• Develop potential solutions
• Develop the Should Be state
• Communicate all changes
• Track implementation progress
• Document results
• Present results

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Analyzing A Flow Chart

• Examine each
• Activity symbol value/cost?
• Decision point necessary/redundant?
• Rework loop time/cost?
• Handoff is it seamless?
• Document or data point useful?
• Wait or delay symbol why?/reduce/eliminate
• Transport Symbol time/cost/location?
• Data Input Symbol right format/timely?
• Document/Form Symbol needed/cost/value?

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How Improvements Are Made

• Focus on Critical Processes
• Important sets of procedures or patterns of tasks
  that determine success (i.e. customer
  satisfaction) for an organization or an
  individuals job.

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Improvement Opportunities

• What to look for on a Flow Chart
• Duplication of effort
• Unnecessary Activities/Steps/Tasks
• Delays/Waits
• Transports
• Storage
• Illogical Sequencing of Activities
• Unclear Lines of Responsibility
• Opportunities for Error
• Supplier Error Opportunities
• Disconnects

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How Improvements Are Made

• Standardizing all the same
• Automating if possible Timing?
• Eliminating unnecessary steps/waste
• Combining/Rearranging parts/steps
• Simplifying reducing complexity
• Changing people/place/sequence
• Reducing storage/transports/rework

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Advantages of Flow Charts

• Overview of the System
• Documents a system/process
• Shows Interrelationships
• Communication Tool
• Defines Roles
• Shows barriers/bottlenecks/problems
• Planning Tool for improvements

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Flow Charting

• Improvement
• Requires
• Change
• Needs
• Action
• Requires
• Process Knowledge
• Requires
• Experienced People