Essay on Creating a Flowchart in Healthcare

The creation of flowcharts in healthcare is a significant process for the organization of a task. Workflow is a series of tasks completed by a variety of people within a work environment. The utilization of flowcharts and the examination of the workflow surrounding your organization can provide better use of technology, promote safer patient care delivery, and encourage more efficient work CITATION McG15 \l 1033 (McGonigle & Mastrian, 2015). Flowcharts allow you to use shapes to illustrate how a process is accomplished so that you can understand the current method and develop new techniques to improve it CITATION Ins161 \l 1033 (Institute for Healthcare Improvement, 2016). Flowcharts assist in clarifying complicated processes; recognize steps that do not add value to the process, and help staff members gain an understanding of the procedure to utilize it CITATION Ins161 \l 1033 (Institute for Healthcare Improvement, 2016).

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Transferring a patient from the intensive care unit (ICU) to another facility can be a relatively easy process when completed correctly. The implementation of a good workflow can make this task fast and stress-free for the patient and their family. The purpose of this paper is to analyze the workflow of transferring patients out of ICU to another facility. The analysis of this workflow will determine if the current system is the appropriate method to ensure a stress-free experience for the patient.

Transferring Patients from ICU to Another Facility

The process of transferring a patient to another facility can be lengthy, but with the use of a proper flowchart, it can be effortlessly completed. Once receiving an order to transfer a patient to another hospital numerous steps are entailed. The diagram included below will show you the basic steps utilized at my facility, Saint Marys Regional Medical Center.

The first step in transferring a patient from ICU to another facility would be to receive a physician order to transfer.The physician will input the order in the computer, using our electronic health record (EHR) system. Once this orderis obtained, the doctor and nurse will speak with the patient and their family about why the patient requires transfer to another hospital. If the patient is unconscious, we would then speak to the next of kin or power of attorney (POA) and explain the reasoning. Consent for transfer must be obtained from the patient, next of kin, or POA. If the patient or family agrees with the transfer, then the real process begins. If they disagree with thetransfer, they will then be provided with information on what or could happen if they patient stay at the current facility. At that point, the patient must decide their treatment options going forward.

The physician must then find an accepting physician and an accepting facility.He will do this by calling other hospitals and speaking with a physician exchange representative, notifying them of the condition of our patient and why we needto transfer to their facility. An accepting physician from the other facility will call our doctor back and agree to transfer. Once this has been established the ICU nurse will speak with bed control at the other facility, via telephone, and wait for a room assignment before transporting the patient. While the ICU nurse waits for a room assignment, numerous things happen simultaneously to prepare for transport. The nurse will notify the house supervisor and case management nurse of transfer orders. The case manager helps print off the patients chart and calls radiology for copies of x-rays and exams. The patients chart is found on the EHR system and can easily be printed. The physician will decide what method of transport is best for the patient and inform the ICU nurse. The mode of transportation is determined based on the patients condition, weather conditions, medical interventions required, the availability of transport personnel, and the time it takes to get to the other facility. The appropriate paperwork for transfer will be printed, using documents that are saved under a downtime folder, and signed by the doctor and patient. When a room assignment is available, the ICU nurse will call the accepting facility with a nurse-to-nurse report on the patient. After report has been called, the ambulance crew or helicopter company will be notified that a transfer is needed. The transport team will give an estimated time of arrival, and the nurse will then update the patient and family. Once the transport teamhas arrived, the patient will be loaded onto the stretcher with their chart, belongings, and proper equipment. As the transport team is leaving, the nurse will notify the accepting nurse that the patient has left the current facility.

Metrics Used to Measure Workflow

Metrics offer a comprehension of the performance of a function or process CITATION McG15 \l 1033 (McGonigle & Mastrian, 2015). Time, quality, and cost are variables that metrics focus on. McGonigle and Mastrian (2015) list eight cases in point of metrics: change-over time, turnaround time, patient satisfaction, set-up time, cycle times, employee satisfaction, system availability and throughput. Turnaround time and patient satisfaction are metrics used to measure workflow. Turnaround time in the ICU can be a long process or short process. It all depends on your patients, the census of the hospital, or where you are transferring a patient to. The implementation of this current workflow has made the process of transferring a patient to another facility more effective and time efficient. Patient satisfaction informs the facility of how their performance was. The patient can leave feedback on whether their transfer was handledpromptly and if they were updated on the process.

Areas of Improvement

Although our current system for transferring patient seems practical and time efficient, there is always room for improvement. Communication is essential when moving a patient from one facility to the next. Waiting for a room assignment is usually the process that is the most time consuming. Most facilities will accept a patient but will not have a room available. Sometimes this can take days. Luckily our facility is close to numerous larger facilities with specialties, so our physicians usually call multiple hospitals to be placed on a waiting list for a bed assignment.

Summary

The healthcare environment is evolving daily. Workflow often suffers from the changes in technology. There is a great need to redesign the workflow to adapt to the new technology. A flowchart can identify areas that are flawed and need improvement. It is imperative to have a reliable workflow system in place when transferring a critically ill patient from ICU to another facility. A good workflow will help accomplish those goals in a timely manner, leading to care that is delivered more consistently, reliably, safely, and in compliance with standards of practice CITATION Cai08 \l 1033 (Cain & Haque, 2008). References

BIBLIOGRAPHY Cain, C., & Haque, S. (2008). Organizational Workflow and Its Impact on Work Quality. In R. G. Hughes (Ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2638/

Institute for Healthcare Improvement. (2016). Flowchart. Retrieved from Institute for Healthcare Improvement: http://www.ihi.org/resources/pages/tools/flowchart.aspx

McGonigle, D., & Mastrian, K. G. (2015). Nursing Informatics and the Foundation of Knowledge (Third ed.). Burlington, MA: Jones & Bartlett Learning.

Warren, J., Fromm Jr, R. E., Orr, R. A., Rotello, L. C., & Horst, H. M. (2004). Guidelines for the inter- and intrahospital transport of critically ill patients. American College of Critical Care Medicine, 32(1), 256-262. Retrieved from http://www.learnicu.org/docs/guidelines/inter-intrahospitaltransport.pdf