Ambulatory Clinic Process Engineering

Business Case:

An academic medical center was preparing to implement an Electronic Medical Record (EMR) in their network of outpatient clinics. Implementation of the system required documentation and validation of current workflows for providers, nurses, and front desk staff. Additionally, the client required future state workflows to identify potential operational efficiencies that could be realized through a business transformation effort. The client also requested a repeatable process engineering analysis methodology be used during the engagement and transitioned to internal staff for use on future internal efforts. 

Solution: 

The CapTech Way Process Engineering Methodology was leveraged to analyze 65 clinics’ current state processes, propose future state processes, and deliver a repeatable methodology with templates for each phase of the methodology.

In the “Analyze” phase of our methodology, CapTech interviewed providers, nurses, and front desk personnel at client-selected clinics. These interviews gathered pertinent details of existing clinic processes, while also soliciting opinions on issues and potential improvements. CapTech then facilitated focus group sessions for each process area. The focus groups ensured appropriate stakeholders reviewed the 29 current state workflows, covering nursing and provider documentation, order entry, and medication management. The venue provided these stakeholders opportunities to voice concerns or questions, and ultimately gained sign-off of the accuracy of the captured workflows.

CapTech then led process visioning activities with client resources to identify potential improvement opportunities and target metrics for each clinic workflow. Nominal group technique was employed to help SMEs rank and order proposed opportunities according to potential improvement and disruption possibilities to the clinics, and on-line surveys enabled efficient input on proposed ideas from representatives of all clinics.

In the “Model” phase, highly-ranked improvement opportunities were incorporated into 20 proposed future state workflows.  Eliminating paper documentation and identifying one system of record for each process were the unifying themes of the proposed flows.

Tools: 
  • User Surveys and Interviews
  • Microsoft Visio
  • Process Details Forms and Analysis Worksheets
  • Nominal Group Technique
  • Value Stream Maps and Future State Scope Statements
Results: 
  • Input from over 150 clinic resources at all organizational levels which expanded staff buy-in to the EMR implementation.
  • Future state flows improved process efficiencies, quality, and customer service, while reducing labor hours and cycle times.
  • A defined road map for implementation, which highlighted critical impacts on stakeholder groups leading to valuable integration and risk remediation discussions.
  • The client was positioned with trained resources, re-usable templates, and a repeatable methodology.