Check One:
Company Name:
Process Name:
Process Location:
Step Nbr
Flow
Type
Activity Description
Clock
Time
Elapsed
Time
Prepared By:
Date:
Flow of Information
Video Taped:
Tranport
Distance
UOM
Total Summary
Flow of Customer
Flow of Unit
Flow of Worker
Transport
Wait Time
Time
Yes/No
NVA
Process
Time
Inspect
Time
VA
Process
Time
UOM
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
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Template
Process Flow Analysis
25
26
27
28
29
30
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Template
Process Flow Analysis
Check One:
Company Name: ABC Hospital
Process Name:
Outpatient Surgery
Process Location: ABC Hospital Surgical Services
Step Nbr
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Flow
Type
W
T
NVA
T
NVA
T
W
T
VA
T
I
VA
W
VA
W
VA
W
VA
VA
W
VA
VA
VA
W
Activity Description
Total Summary
Walk In
Wait in admitting waiting room
Walk to admitting desk
Admitting Check In
Wlk to PreOp Check In
Check In PreOp
Walk to Holding Waiting Area
Wait in Holding Waiting Room
To bathroom on way to holding
Bathroom
To Holding area bed G
Tech perform vital signs and property list
Change clothes
Wait on stretcher
Nurse assess and consent forms
Wait
Nurse start IV
Wait
Anesthesiologist Assessment
RN Labs and prep
Wait
Anesthesiologist Admin RX
Circulating Nurse in to Assess
Surgeon arrive and assess
Wait
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Clock
Time
Elapsed
Time
5:44
5:44
5:52
5:53
5:57
6:01
6:02
6:03
6:12
6:13
6:14
6:15
6:19
6:21
6:23
6:30
6:33
6:38
6:52
7:04
7:05
7:08
7:14
7:16
7:29
Minutes
114
0
8
1
4
4
1
1
9
1
1
1
4
2
2
7
3
5
14
12
1
3
6
2
13
9
Sample
Flow of Customer
Flow of Unit
Flow of Worker
Prepared By:
Date:
Jane Doe (BB)
Sept. 1, 2007
Flow of Information
Video Taped:
Yes
Tranport
Distance
Feet
607
Transport
Wait Time
Time
48
NVA
Process
Time
Inspect
Time
VA
Process
Time
49
8
8
1
4
483
25
1
9
28
1
1
63
1
4
2
2
7
3
5
14
12
1
3
6
2
13
9
Process Flow Analysis
25
26
27
28
29
30
Begin procedure
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7:38
Sample
Process Flow Analysis