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Strategy Submission

Using Process Flow Charts to Improve Clinical Care


Leslie W. Hall



Associate Professor of Clinical Internal Medicine



University of Missouri - Columbia


Competency Categories:

Quality Improvement

Learner Level(s):

Graduate Students, New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN

Learner Setting(s):


Strategy Type:

Online or Web-based Modules

Learning Objectives:

At the completion of this session, the learner will:

  • Demonstrate an understanding of how information regarding a care process can be organized into a process flow chart
  • Understand how the process flow chart may help to identify unwanted variation in a clinical process
  • Understand how the process flow chart may be utilized to identify high impact areas for instituting change in a clinical process

Strategy Overview:

This relatively simple exercise provides an opportunity for nursing
students to examine a common clinical care process (administration of
inpatient antibiotics) that is not occurring efficiently and examine
what some of the root causes might be that are causing the delays. The
concept of a process flow chart is introduced as a tool to identify high
impact areas that might be high leverage areas for change. The chart is
also introduced as a tool that can be used to identify practice
variations. The importance of this exercise is to introduce the idea
that an inefficient process can be reduced to a series of clinical
steps, rather than viewing it as dysfunctional individuals (which
usually leads to feelings or statements of blame). Identification of the
high impact change areas can allow interventions to be appropriately
focused where the greatest benefit will accrue.

Submitted Materials:

Additional Materials:

Evaluation Description:

This teaching exercise has been used in a variety of small group learning environments, with positive feedback from learners. Although it has not been utilized by the author in independent study or as part of a computer-based module, the content is probably amenable to delivery by these methods as well.
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