Many of the symbols commonly used to make flowcharts are shown in Figure 17.2.
• The oval indicates the beginning point and the ending point of the process you are mapping. When you first start to make a flowchart of a process, it becomes very obvious why having a global aim statement with a clearly stated start point
FIGURE 17.2. FLOWCHART SYMBOLS.
Process flow direction
Connector (for example, to another page)
and end point is fundamental to process improvement work. The beginning and the end of the process, as specified in this statement, define the boundaries of the flowchart you will create.
• The box represents an activity step.
• The diamond shows a decision point in the process, where one must respondjyes or no. A yes or no decision point leads to a distinct flow for each of its two options.
• The elongated D depicts delays in the process. This symbol should alert you to further evaluate this step to understand the sources of waits and delays.
• The arrow shows the directional flow of the process.
• The circle indicates that the steps continue on another page or on another part of a larger flowchart. A letter placed in the circle tells you where to pick up the process on the next page.
• The cloud represents don't know; what happens in this step is not known or understood. When an interdisciplinary team cannot describe a step, it is a signal that one or more people who are part of the process are not contributing to the discussion. Further discussion should follow with those involved in this step. You may wish to add people to the lead improvement team to ensure that all who have a role in the current process are involved in flowcharting that process. Alternatively, you may simply need to review the flowchart with others to get all parts of the process mapped correctly and accurately. Note also that differing views about a process are normal and reflect the differing ways that the various health professions do their work. It is helpful to reconcile those differences from the viewpoint of the patient and family whenever possible.
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