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Author: Elyse, PMP, CPHIMS
January 6, 2010

Redesigning workflow is a critical component of any healthcare system implementation. Honestly, if you don't review the current state and develop the new workflow as a part of implementation, you will at the most inopportune time. Most likely in the company of process improvement, corporate compliance, quality management, and a plethora of frustrated clinicians, after a patient care event has occurred.

As a part of system consideration and value determination, it is necessary analyze workflow. So let's review the gotcha assumptions which are sure to hurt later in the process to avoid them at all costs.

The Top 6 WorkFlow Design Pitfalls

  1. Automating a bad process will just make it fail faster and magnify the problem. - There is a reason, you are investing in a new system. It maybe to change what and how your group is working to realize more revenue, increase patient safety, increase efficiency holistically. It is just not a good practice to have a new system, and customize it to identically match the system or process you are replacing.
  2. Clinical process maybe the art of the workaround - Recognize there are many problems within the current workflow which are not brought out into the light of day. Engage the team in open dialogue and capture these in the current state, try to avoid workarounds in the future state
  3. Grandiose Workflows - The goal is to simplify for the future. The larger, more complex a workflow becomes correlates directly to implementation problems and dissatisfaction. Try to Keep It Simple, Smarty.
  4. The EHR System (Electronic Holistic Reminder) - If you suddenly realize through alerts and rules, your electronic health record is now just a plethora of annoying alerts and reminders. It is too much at one time and alert overload. Time to take a step back and deliberately consider rolling in a couple of rules and alerts at a time.
  5. Everyone does workflow the exact same way - My colleagues, this is simply not true. Do not assume workflow is identical across multiple physician offices, services, or hospitals. Dive deep into the details and discover how surgery, cardiology, and neonatal differ in their workflows.
  6. Engineering for all the exceptions, not the mainstream - If workflows are derived from variation, take a step back and re-engineer for the 80 percent which is done the same way for most. Have the variations labeled as parking lot and assess the merits. Try to bunch up the variations in groups, and then account for the heavy hitting groups.

The TakeAway

The key to a successful workflow design is to be focused upon measure improvement with the ability to optimize in the future with additional rules and alerts. Avoiding these common pitfalls,your team has a good change to develop a workflow which works for all. Please feel free to share your pitfalls and best practices on this topic, it is better to learn from the wisdom of others. If you enjoyed this post, you may also want to read these other posts:

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