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
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Rapid
Cycles
Innovative
Ideas
Fix a Key
Problem
i2 Chart
S.E.A. Boards
Good
Change
Leader
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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?)
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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”
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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
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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
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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
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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
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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
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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
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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
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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
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0
10
How DIFFICULT is it to do?
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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
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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
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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
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Reduce Waiting & No-Shows • Increase Admissions & Continuation
Caveat
Avoid
ANALYSISPARALYSIS!
Use
DISCRETION time is precious!
“Scream” (Edvard Munch)
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..map out the system - the inputs, processes, and outputs …
http://www.pottersbrewery.com.au/gfx/Potters%20Brewery%20Flow%20Chart.jpg
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Reduce Waiting & No-Shows • Increase Admissions & Continuation
…in a clear, understandable way….
Photo taken from: http://s89015200.onlinehome.us/thepaperfold/crab.htm.)
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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)
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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
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…facilitates easy measurement and consistency of output…
Photo taken from: http://vegetarian.allrecipes.com/az/PhadThai.asp
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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
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…allows you to see/infer causes and effects….
http://www.grantlairdjr.com/file/How_StarWars_Changed_the_World.jpg
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… affords quick troubleshooting …
Adapted from: http://www.softlab.ece.ntua.gr/~sivann/pub/funnypics/troubleshooting-chart.jpg
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Reduce Waiting & No-Shows • Increase Admissions & Continuation
…facilitates idea generation…
Adapted from: http://www.adaptivepath.com/images/publications/essays/desirelines.jpg
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…promotes transparency and accountability…
Photo taken from: http://www.wheelbarrowsoftware.com/fpd_full_screen.htm
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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
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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
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Reduce Waiting & No-Shows • Increase Admissions & Continuation
…leads to less meetings; and tells you where to go next
Photo taken from: www.despair.com
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Reduce Waiting & No-Shows • Increase Admissions & Continuation