Process Mapping and Other Visual Modeling Tools
Transcription
Process Mapping and Other Visual Modeling Tools
Process Mapping and Other Visual Modeling Tools Joey Valdez, MS (javaldez@chess.wisc.edu) PhD Student in Industrial and Systems Engineering University of WisconsinMadison NIATx National Program Office Reduce Waiting & No-Shows • Increase Admissions & Continuation www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation Some Visual Modeling Tools 5 Key Principles Flowcharting Swimlane Diagram Tug-Of-War Diagram www.DO Chart Focus on Customer Fishbone Diagram Cause-Effect Digraph www.NIATx.net Rapid Cycles Innovative Ideas Fix a Key Problem i2 Chart S.E.A. Boards Good Change Leader Reduce Waiting & No-Shows • Increase Admissions & Continuation Flowcharting 101 • Orientation: print: top-down; board: left-right • Symbols: Start Process Decision End Point Off-Page Connector • Number the items for easy reference • If it’s too complex, break it down to smaller, manageable parts; (maybe that’s the problem?) www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation Swimlane Diagrams tell you who does what…. when and how long What are the time traps? What are the capacity constraints? Now you’ve identified the current “as is” process, you can try to map out what “should be” www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation Fishbone Diagram 1. Brainstorm the potential causes of the problem 2. Group similar ideas/concepts together Consumers have preferences for particular groups, particular topics, and particular group leaders and not others Staff presentations need better preparation Consumers need clarification about control of their finances once they leave treatment Consumers have tremendous need for education and clarification about housing options Group schedule needs to be posted so that consumers are aware of range of choices 3. If it’s too complex, break up the diagram into manageable parts 4. Choose the biggest problem area We have low continuation rates! Clients have concerns about control of their finances once they leave treatment Environmental space needs to be reworked Some working consumers do not include treatment in their schedule Family services are a needed adjunct to treatment Housing specialist position needed at CCT www.NIATx.net PALLADIA, Inc. (Bronx, NY) The residential completion letter does not give the message that aftercare is part of treatment Topics at presentations do not address central concerns of clients – including success stories of their peers Reduce Waiting & No-Shows • Increase Admissions & Continuation Improvise! Screening staff setting aside an hour to just return calls in one day Give a choice and benefits of starting treatment on the same day Add other back up staff; Victor and Rommark to be available for calls Client Staff change for more effective time and resource management Add back up assessment staff to reduce waiting time for assessment Process problems up to assessment Front desk staff Process problems after assessment Translators Treatment Delay in time from 1st Request to 1st Treatment Asian Counseling & Referral Services (Seattle, WA) Provide clear instruction and staff information to direct phone calls www.NIATx.net Utilize and match client with bilingual staff for assessment instead of using interpreter service Add backup staff Set a clear expectation about collateral information. Try 3 times in 3 days. If unsuccessful, will complete the paperwork without the collateral information Reduce Waiting & No-Shows • Increase Admissions & Continuation Cause-Effect Digraph 1. Brainstorm the potential causes of the problem, and label these nodes A, B, C,….. A 2. Identify which causes what and draw arrows. (If it’s too complex, break up the diagram into manageable parts) E Lobby does not feel welcoming Clients decide not to show up B H Time b/w first request and engagement is too long We have high no show rates 3. Count the number of arrows coming into and out of each node, and determine the causes and indicators. F Clients decide to leave clinic C NODE Inefficient appointment scheduling system G Too much paperwork D Staff is overworked Therefore: • Work on the causes • Measure/monitor the indicators www.NIATx.net COUNT THE NUMBER OF ARROWS GOING OUT IN A 1 1 B 2 1 C 3 0 D 1 2 E 1 1 F 1 3 G 3 1 H 0 2 Reduce Waiting & No-Shows • Increase Admissions & Continuation Causes: nodes that have most number of arrows coming out Indicators: nodes that have most number of arrows coming in S.E.A. Board Stories www.NIATx.net Experiences Artifacts Reduce Waiting & No-Shows • Increase Admissions & Continuation i2 Matrix 1. Brainstorm potential solutions to problem (i.e., use the NGT) and number them (I.e., solution numbers 1…8) Exciting 2. Place each solution in one of the four regions of the 2 x 2 matrix 3. Choose a solution (or group of solutions) that’s relatively easy to do, yet excites people POTENTIAL SOLUTIONS BRAINSTORMED: 1 Reshuffle/postpone paperwork 2 Cross-train staff 3 Innovation It takes forever for patient to get from first contact to 1st pre-treatment session! 1 (exciting and easy) 7 3 Structure encounter as an “experience” 5 8 4 (exciting but difficult) 2 6 5 Have counselors finish paperwork later 6 Redesign paper forms 7 Divide tasks and have people specialize 8 TV/snack breaks www.NIATx.net Simple 4 Computer-based information system (simple and easy) (simple and difficult) Difficult Easy Implementation Reduce Waiting & No-Shows • Increase Admissions & Continuation A variation of the concept…a “screening matrix” 1. 10 Same thing - brainstorm potential solutions to problem and number them 2. Rate solutions with respect to degree of difficulty and the degree of innovativeness (i.e., 0-10) 3. This provides a way to tease out the better solutions 1 Reshuffle/postpone paperwork 4 3 1 How EXCITING is it? 8 2 2 Cross-train staff 3 Structure encounter as an “experience” 5 4 Computer-based information system 6 5 Have counselors finish paperwork later 6 Redesign paper forms 7 7 Divide tasks and have people specialize 8 TV/snack breaks www.NIATx.net 0 10 How DIFFICULT is it to do? Reduce Waiting & No-Shows • Increase Admissions & Continuation Tug-O’-War Diagram Fear of change Might cost more than budget! Everyone wants the system to change Our competitors are doing it! New computerized appointment scheduling system The status quo Takes time to get used to new system It was the boss’ idea! Just hired David who’s an ace programmer Anticipating and addressing these barriers to change makes project execution less difficult www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation www.DO Chart WHO WHAT WHEN Gather data on arrival, service times Jean*, Ben, Wanda 9/1-9/5 Determine peak hours and figure out appropriate staffing Steve 9/8-9/10 Try out new system and gather feedback Peter*, Jean, Tony, Emma 9/11-9/19 Refine and make decision to adopt Whole team, Steve* 9/22, 1pm meeting www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation Let’s try it … • Map out (using a flowchart or swim-lane diagram) a process (i.e., intake, transitioning across levels of care, etc.) you wish to improve in your organization and/or • Choose a key problem and analyze causes (and effects) using a fishbone (or cause-effect) diagram and if there’s time…. • Brainstorm solutions and evaluate these with respect to degree of innovativeness and ease of implementation www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation Caveat Avoid ANALYSISPARALYSIS! Use DISCRETION time is precious! “Scream” (Edvard Munch) www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation ..map out the system - the inputs, processes, and outputs … http://www.pottersbrewery.com.au/gfx/Potters%20Brewery%20Flow%20Chart.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …in a clear, understandable way…. Photo taken from: http://s89015200.onlinehome.us/thepaperfold/crab.htm.) www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation ….and is sometimes worth more than a thousand words…. Photo taken from ACTION PHILOSOPHERS #3 (http://www.comicon.com/pulse/images_05a/1acph7.jpg) www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …lets you see the highs and lows of the process … Photo taken from: http://g.sheetmusicplus.com/Look-Inside/large/wb-f3336smc.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …facilitates easy measurement and consistency of output… Photo taken from: http://vegetarian.allrecipes.com/az/PhadThai.asp www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …lets you know how far there is to go… Photo taken from: http://www.letour.fr/2005/TDF/LIVE/images/carte.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …allows you to see/infer causes and effects…. http://www.grantlairdjr.com/file/How_StarWars_Changed_the_World.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation … affords quick troubleshooting … Adapted from: http://www.softlab.ece.ntua.gr/~sivann/pub/funnypics/troubleshooting-chart.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …facilitates idea generation… Adapted from: http://www.adaptivepath.com/images/publications/essays/desirelines.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …promotes transparency and accountability… Photo taken from: http://www.wheelbarrowsoftware.com/fpd_full_screen.htm www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …provides flexibility and makes it easy for new “players”… Photo taken from: http://www.game-warrior.com/images/articles/chutes_ladders.jpg www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …makes communication more effective… Photo taken from the article “The Shape of Things to Come”, The Economist, Dec. 13, 2003 www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation …leads to less meetings; and tells you where to go next Photo taken from: www.despair.com www.NIATx.net Reduce Waiting & No-Shows • Increase Admissions & Continuation