A workflow is a set of tasks grouped into a process that requires the interaction of people and resources to complete the defined goals. The method of checking the workflow (such as care coordination, equipment optimization, or ER admission) in a hospital or clinic can optimize the system to increase efficiency, safety, and satisfaction. In this article, we will review how healthcare system workflows can help characterize and develop usability design methods to increase efficiency, reduce risk, supervise confusion, and benefit patient care.
In the healthcare field, processes may depend on each other and overlap different areas of responsibility, which may affect the patient’s experience and results. For example, in a hospital environment, the ED team and the ICU team may be involved in the same patient care continuum, but contain different roles and responsibilities, such as unique equipment, protocols, and reporting requirements, so the workflow is different. Although there is agreement on what to accomplish, when different work processes or unexpected events occur, these tasks may cause damage, affect efficiency, or increase risk. Interactions between different processes, technologies, resources, and individuals can lead to complexity, challenges, or key points.
The continuous care journey that involves patients and their loved ones involves the quality of care and the commercial benefits of the hospital. The continuity of care, clinical efficacy, patient safety, and medical legal affairs involve procedural agreements. A rigorous approach can simplify continuous care through observational studies that provide information for the development of infographics and flowcharts. Collaborative analysis can transform research results into insights and characterize key points/needs. Continue collaborative methods, such as cross-functional workshops, to generate actionable requirements and conceptual suggestions for the optimization of new or existing systems.
In the first few months of the pandemic sweeping the country and overwhelming hospitals and nursing practices, the organization re-examined how providers and patients interact with the healthcare system to best configure workflows to deal with the impact of nursing critically ill patients. The process mapping method can meet this requirement of the system and the work process, making it more flexible and subject to risk prevention review.
Usability design-a new way forward
The idea of reconfiguring healthcare workflows or knowing whether changes are needed can be daunting, but can be achieved by following a usability design process with specific milestones and guidance based on a well-thought-out project plan.
This approach lays the foundation for the development of new systems/processes/workflows/best practices. For example, such findings cover the challenges and behavioral patterns of understanding workarounds. Did these workarounds succeed in one area, but did they introduce risks in another area of the care continuum? Can they be modified or enhanced to achieve the goals of all relevant personnel?
This foundation helps to identify obstacles that affect the efficiency, health, safety, and risk management of patient care and supervision. It raises everyone to the same level of understanding—operations, management, clinicians, patients, technicians, risk management, etc.—all are interested in successful clinical results and are part of active planning. The map became the Rosetta Stone for collaboration.
The mapping process can provide the following insights:
- Reveal the verbal and unspoken needs, challenges and wishes of applicable stakeholders
- Identify and describe usability challenges, risks, near misses, workarounds, and impacts
- Discover new opportunities for improvement and innovation
- De-skills program (design a program so that users of all levels can get the best results)
Mapping can visualize various aspects of relevant insights and indicators:
- Time/exercise efficiency
- User roles and responsibilities
- Device interoperability
- Resource life cycle and waste
- Use error
The resolution of the flow chart is a function of the range focal point of view. The focus can be fine-grained or broad, as shown below:
- Surgical treatment
- Disease state
- Environment, such as ICU, OR, imaging, central supply, IR laboratory, etc.
- Continuous care, for example, patient/family trip
- Equipment life cycle
Plan strategic initiatives
The project charter defines the overall objectives and strategic approach. As the project progresses, the charter should be flexible and can be modified when necessary, if previously undiscovered opportunities or challenges are revealed.
Next, build deliverables. Regarding the charter goals, what is the outcome of the project? Based on newly discovered insights, deliverables may need to be updated throughout the project. The next step is to identify stakeholders and introduce them to the project plan and its deliverables. Once the mission of optimizing the system begins—whether in the entire healthcare organization, continuous care, or a specific focus on a procedure, collaboration will become the basis for success.
Research, creative fuel
Developing a method of collecting data to provide information for the mapping process is key. Better methods usually use different methods to discover the truth, such as a combination of subjective and objective techniques. The shortcomings are often exposed in methods such as surveys and questionnaires. First, you must assume that you know the right question to ask, and depending on the way you ask the question, you can get different answers. So, what if you don’t know what you don’t know? Second, the answers of study participants are subject to a lot of bias; the most common is memory inaccuracy.
An observation method, such as contextual investigation or ethnography, can minimize prejudice and does not rely on knowing the right questions to ask—”Show me, don’t tell me.” For example, ask questions such as “How did you accomplish this?” Task?” Such questions. It will definitely lead to the answer, usually their expectation of the “correct” answer. However, observing team actions in real time can lead to slightly different or even very different practices that may affect the final design of the workflow. It’s not that interviews are useless, especially if they obtain information through observational methods. In addition, there are a variety of techniques to minimize deviation.
Analysis, the cornerstone of the project
Regardless of the method used, such research will generate a large amount of data that needs to be parsed. This is the most critical step. There are many techniques, many of which involve cross-functional teams, used to decompose research results into related groups, identify patterns and trends, use related risk assessments, and determine root causes to characterize problems. The analysis may require further research, as gaps have been found and questions you don’t know to ask. Data will evolve from original discovery to insight and then to demand.
Integrated research into action
If the analysis breaks the data down into its basic components to understand relationships and patterns, then synthesis recombines the data in novel ways to create new ideas. Translating research insights into user needs, actionable needs and concepts ultimately requires the support of stakeholders involved in the process. A well-planned seminar plan may include:
- Location/review of maps and research results emphasizes key points and patterns
- Group discussion review to identify problem statements and innovation opportunities
- Different ideas for cross-functional teams to solve each problem statement and opportunity
- Cross-functional teams develop fusion ideas of different ideas output
- Develop brainstorming output into requirements and concept proposals
- Prioritization and coding of workshop outputs
- Summarize the next steps, timetables and milestones for achieving the deliverables of the charter
The workflow in the healthcare system is affected by many internal and external factors. If the workflow is not flexible and regularly customized, it may reduce efficiency, introduce risks and regulatory confusion, and ultimately affect the patient’s treatment effect. Under the guidance of usability experts, a workflow design process can be developed to illustrate best practices and optimize continuous care.