Process Mapping in a Pediatric Emergency Department to Minimize Missed Urinary Tract Infections

Black, Morgan; Singh, Valene; Belostotsky, Vladimir; Roy, Madan; Yamamura, Deborah; Gambarotto, Kathryn; Lau, Keith K; Kam, April J.

doi:10.1155/2016/2625870

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…Studies reported that QI teams gained a more realistic understanding of current practice because PM allowed them to gather knowledge from people directly involved in the process under analysis and provided a visual representation of current or enhanced processes [ 65 , 83 , 96 , 142 ]. The studies show that PM is a tool to break-down the complexity characterizing healthcare, by providing improvement teams with a structured picture of complex processes, using information from process stakeholders holding different roles and perspectives [ 34 , 88 , 90 , 96 , 98 – 100 , 140 ].…”

Section: Resultsmentioning

confidence: 99%

Process mapping in healthcare: a systematic review

Antonacci

Lennox

Barlow

et al. 2021

BMC Health Serv Res

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Introduction Process mapping (PM) supports better understanding of complex systems and adaptation of improvement interventions to their local context. However, there is little research on its use in healthcare. This study (i) proposes a conceptual framework outlining quality criteria to guide the effective implementation, evaluation and reporting of PM in healthcare; (ii) reviews published PM cases to identify context and quality of PM application, and the reported benefits of using PM in healthcare. Methods We developed the conceptual framework by reviewing methodological guidance on PM and empirical literature on its use in healthcare improvement interventions. We conducted a systematic review of empirical literature using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Inclusion criteria were: full text empirical study; describing the process through which PM has been applied in a healthcare setting; published in English. Databases searched are: Medline, Embase, HMIC–Health Management Information Consortium, CINAHL-Cumulative Index to Nursing and Allied Health Literature, Scopus. Two independent reviewers extracted and analysed data. Each manuscript underwent line by line coding. The conceptual framework was used to evaluate adherence of empirical studies to the identified PM quality criteria. Context in which PM is used and benefits of using PM were coded using an inductive thematic analysis approach. Results The framework outlines quality criteria for each PM phase: (i) preparation, planning and process identification, (ii) data and information gathering, (iii) process map generation, (iv) analysis, (v) taking it forward. PM is used in a variety of settings and approaches to improvement. None of the reviewed studies (N = 105) met all ten quality criteria; 7% were compliant with 8/10 or 9/10 criteria. 45% of studies reported that PM was generated through multi-professional meetings and 15% reported patient involvement. Studies highlighted the value of PM in navigating the complexity characterising healthcare improvement interventions. Conclusion The full potential of PM is inhibited by variance in reporting and poor adherence to underpinning principles. Greater rigour in the application of the method is required. We encourage the use and further development of the proposed framework to support training, application and reporting of PM. Trial Registration Prospero ID: CRD42017082140

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Section: Resultsmentioning

confidence: 99%

Process mapping in healthcare: a systematic review

Antonacci

Lennox

Barlow

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Most (91%) reported that the map was created to represent "as-is" practice. Four projects [75][76][77][78] reported both "as-is" and "to-be" maps, while 5 describe the "to-be" process. [79][80][81][82][83] For example, in TDABC projects the analysis is focused on process costs and is mainly completed after the "as-is" process map is created.…”

Section: Phasementioning

confidence: 99%

Process Mapping in Healthcare: A Systematic Review

Antonacci

Lennox

Barlow

et al. 2020

Preprint

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Introduction Process mapping (PM) supports better understanding of complex systems and adaptation of improvement interventions to their local context. However, there is little research on its use in healthcare. This study (i) proposes a conceptual framework outlining quality criteria to guide the effective implementation, evaluation and reporting of PM in healthcare; (ii) reviews published PM cases to identify context and quality of PM application, and the reported benefits of using PM in healthcare.Methods We developed the conceptual framework by reviewing methodological guidance on PM and empirical literature on its use in healthcare improvement interventions. We conducted a systematic review of empirical literature using PRISMA methodology. Inclusion criteria were: full text empirical study; describing the process through which PM has been applied in a healthcare setting; published in English. Databases searched are: Medline, Embase, HMIC–Health Management Information Consortium, CINAHL-Cumulative Index to Nursing and Allied Health Literature, Scopus. Two independent reviewers extracted and analyzed data. Each manuscript underwent line by line coding. The conceptual framework was used to evaluate adherence of empirical studies to the identified PM quality criteria. Context in which PM is used and benefits of using PM were coded using an inductive thematic analysis approach.Results The framework outlines quality criteria for each PM phase: (i) preparation, planning and process identification, (ii) data and information gathering, (iii) process map generation, (iv) analysis, (v) taking it forward.PM is used in a variety of settings and approaches to improvement. None of the reviewed studies (N=105) met all ten quality criteria; 7% were compliant with 8/10 or 9/10 criteria. 45% studies reported that PM was generated through multi-professional meetings and 15% reported patient involvement. Studies highlighted the value of PM in navigating the complexity characterizing healthcare improvement interventions.Conclusion The full potential of PM is inhibited by variance in reporting and poor adherence to underpinning principles. Greater rigour in the application of the method is required. We encourage the use and further development of the proposed framework to support training, application and reporting of PM.Prospero ID : CRD42017082140.

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Optimizing Endoscope Reprocessing Resources Via Process Flow Queuing Analysis

2018

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The Massachusetts General Hospital (MGH) is merging its older endoscope processing facilities into a single new facility that will enable high-level disinfection of endoscopes for both the ORs and Endoscopy Suite, leveraging economies of scale for improved patient care and optimal use of resources. Finalized resource planning was necessary for the merging of facilities to optimize staffing and make final equipment selections to support the nearly 33,000 annual endoscopy cases. To accomplish this, we employed operations management methodologies, analyzing the physical process flow of scopes throughout the existing Endoscopy Suite and ORs and mapping the future state capacity of the new reprocessing facility. Further, our analysis required the incorporation of historical case and reprocessing volumes in a multi-server queuing model to identify any potential wait times as a result of the new reprocessing cycle. We also performed sensitivity analysis to understand the impact of future case volume growth. We found that our future-state reprocessing facility, given planned capital expenditures for automated endoscope reprocessors (AERs) and pre-processing sinks, could easily accommodate current scope volume well within the necessary pre-cleaning-to-sink reprocessing time limit recommended by manufacturers. Further, in its current planned state, our model suggested that the future endoscope reprocessing suite at MGH could support an increase in volume of at least 90% over the next several years. Our work suggests that with simple mathematical analysis of historic case data, significant changes to a complex perioperative environment can be made with ease while keeping patient safety as the top priority.

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Process Mapping in a Pediatric Emergency Department to Minimize Missed Urinary Tract Infections

Cited by 4 publications

References 8 publications

Process mapping in healthcare: a systematic review

Process mapping in healthcare: a systematic review

Process Mapping in Healthcare: A Systematic Review

Optimizing Endoscope Reprocessing Resources Via Process Flow Queuing Analysis

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