Process Mappingsometimes called Flowcharting or IS Maps 1 Quality - - PowerPoint PPT Presentation
Process Mappingsometimes called Flowcharting or IS Maps 1 Quality Improvement Works on Existing Processes A process is a series of steps or actions performed to achieve a specific purpose. A process can describe the way things
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performed to achieve a specific purpose.
get done.
Quality Improvement Works on Existing Processes
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sequence of actions that comprise a process.
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work that is being performed.
“You don’t learn to process map, You process map to learn.”
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What Dr. Deming said
“You cannot improve a process until you understand it!” “If you can't describe what you are doing as a process, you don't know what you're doing.”
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get done.
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document.
in the process map creation, or asked for input, or to review drafts as they are prepared.
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action (inputs) to start the process or to show the results at the end (output) of the process.
performed in the process. Although multiple arrows may come into each box, usually only one arrow leaves each box.
yes/no question is being asked or a decision is required.
Flowchart and is continued elsewhere on the same page or another page.
Symbols used to Process Map
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would like the process to be.
it notes, dry erase markers, pencil, etc.
stop points.
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process used to obtain approval to attend conferences.
Process Map of Conference Approvals Sample
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processes you wish to do a process map on.
learn about your organization and work.
Improvement, such as:
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measure improvement vs. change.
that describes the current process.
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Satisfaction with health department services
Survey
write-up that is in your binder
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– From records – Newly collected
that reduces bias
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– Decide what to observe – Define key elements – Established shared understanding
– Identify where, when, & how long – Think about confounding factors
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– Design your check sheet – Develop a protocol
Problem/Project Name: Name of Observer: Other: Location of Data Collection: Dates of Observation: Date tes o s of Data C Collecti tion
Tota
Event ent A B C Tota
Grand Total
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– Identify and train your observers – Practice & adjust
– Collect data – Review & adjust
– Summarize data across observations & observers – Study the results
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– Define, train, check, adjust, & repeat! – Consider and address potential sources of bias
– Fine vs. inclusive categories – Few vs. many categories
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staff track the primary reason for customer dissatisfaction
conditions that they can document:
situation
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80% of the problem
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To identify the causes that are likely to have the
greatest impact on the problem if addressed
“80% of the effects come from 20% of the
causes”
To bring focus to a small number of potential
causes
To guide the process of selecting improvements
to test
Use when you have, or can collect, quantitative
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to study
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primary cause
incidents that fall into each category
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causes should appear in order
with the percentage of occurrences with each cause, and the right y- axis with the cumulative percent.
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solution you want to try?
your aim statement or theory of change (if-then)?
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– Little errors can make a big difference
differently at different points in time
– Revisit your Pareto throughout your project – the meaning may change for you as you go
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Problem: Client Dissatisfaction Name: J. Heany Time: 9-5 Location: Excellence Health Department’s Customer Service Department Dates: Week of 9/6, 9/13, 9/20, 9/27, 10/4, 10/11, 10/18 Date te Tota
Reason son 9/6 9/13 9/20 9/27 10/4 10/11 10/18 Service not offered 3 4 3 2 3 4 19 Service was difficult to access 10 12 6 3 31 Long wait times 2 3 6 1 12 Poor staff interaction 2 2 1 2 1 8 Inaccurate information 2 3 1 2 1 1 10 Tota
17 21 13 12 10 5 2 80
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Problem Solving – What we usually see is the tip of iceberg – “The Symptom”
The Symptom The Root Causes Invisible Hidden
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like to tackle the obvious symptom and fix it
problem and find the root cause is more efficient and effective
apparent on the surface (root cause)
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To identify underlying or root causes of a problem To identify a target for your improvement that is
likely to lead to change
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problem
these arrows with either major causal categories or process categories
Cause 1
Effect/Problem
Cause 2 Cause 3 Cause 4
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Root causes for lack of BCHD general PH articles
Minimal articles Effect Causes People/Staff Media Relations Topics Process No long-term arrangements Secluded media team One writer, poor health Articles for events only Confusion/duplication No time to develop Sporadic writing
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Obese Children
Life Style Polices Environment
TV Viewing No Time For Food Prep No Outdoor Play Unsafe Juices Bottle Pacifier Less Fruits and Veg. Less Income Maternal Choices Less Exercise @ School Curriculum No Sidewalks Unhealthy Food Choices Few Community Recreational Areas or Programs Built Environment For Strollers Not Toddling Less Indoor Mobility TV Pacifier Sodas/Snacks Decreased Breast Feeding
Early Feeding Practices Genetics
Syndromes Genes
Pre Natal Practices
Excess Maternal Weight Gain Over Weight Newborn Over Weight Pre School
Cause and Effect Diagram
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you control or influence
influence
group members feel are particularly important
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Memory Jogger, page 32
major causes, and data related causes (root)
than one major cause area
point
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used to explore the cause/effect relationships underlying a particular problem. Ultimately, the goal of applying the 5 Whys method is to determine a root cause of a problem.
Wikipedia
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service life and has never been replaced. (fourth why)
recommended service schedule. (fifth why, root cause)
Wikipedia
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it is relatively easy to use and apply
deductive exercise conducted in a meeting room where those doing the problem solving are separated from the actual process where the problem occurred. “Go and See”
important, should be grounded in observation, data, and not deduction.
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Using 5 Whys does not always lead to root cause identification because: – Listing causes in the absence of data. – Assumes each symptom has only one sufficient cause. – Varying skill with which the method is applied. – The method is not necessarily repeatable. – Linear approach that does not pick up interactions. – Inability to distinguish between causal factors and root causes.
pick the wrong root cause(s).
cause.
the situation worst.
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received the greatest number of responses as shown in the Pareto Chart (Service was difficult to assess and Service not offered).
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graphically display in increasing detail all of the possible causes related to the problem.
causes rather than symptoms.
cause of the problem we seek to improve.
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tracking process performance
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To study data measured over time Run charts help to:
Study the performance of a process Identify trends Measure change in performance following a
change in process
Use when you have, or can collect:
Quantitative data On a measure of the performance of a process Over time
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points
weekly, daily, hourly?
a trend
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measure
measurement timeframe
measurement point
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Number of New BCCCP Clients by Month in 2007 and 2008
5 10 15 20 25 30 35 40 45 50 January February March April May June July August September` October November December Month Number of New Clients 2007 2008
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points on one side of the center line?
in the same direction (up or down)?
more times in a row?
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– Be cautious about assuming that variation from the average has meaning
– This will help you identify the true mean and the true level of variability within the process
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Month Response rate in ‘08 Response rate in ‘09 January 2 1.8 February 2.3 1.9 March 2.2 2 April 2.5 3.5 May 2.6 3.8 June 2.2 3.9 July 2.1 4 August 1.9 4.1 September 1.9 4.3 October 2 4.5 November 2.1 4.5 December 2.2 4.5 Each month the health department tracks customer satisfaction survey data to measure the impact of implementing an integrated service model starting in April 2009. Client satisfaction measured by mean score on survey item: “The health department makes it easy to get the services I need.”
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