What Does a Completed Fishbone Look Like

Figure 19.4 is a fishbone diagram that shows many of the factors that contribute to the undesirable result of medical appointments that last much longer than needed. The main causal categories are people, equipment, materials, environment, and process. The details within each category reflect why the category is a

FIGURE 19.3. FISHBONE DIAGRAM.

Cause

Contributing

Cause

Cause

Major categories

Contributing

Diagrama Ishikawa

Result

Cause

FIGURE 19.4. FISHBONE DIAGRAM SHOWING CAUSES OF LENGTHY APPOINTMENTS.

Equipment

People

Fishbone Diagram Pharmaceutical

No one responsible for patient flow Support staff not trained

Patients arrive with more needs than originally stated Support staff unprepared for patient visits

No standard registration process

No one responsible for patient flow Support staff not trained

Patients arrive with more needs than originally stated Support staff unprepared for patient visits

Lengthy Appointments

No standard registration process

Medical assistant does paper flow and patient flow Variation in rooming process Poor communication between all staff on patient status Checkout process delays

Materials

Process cause, illustrating the many waits, delays, and flow problems that are specific causes of this (undesired) effect.

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