Continuous quality improvement (CQI) is a continuous effort to improve an

organizations processes in order to better meet the needs of those served.1 Success of a CQI
program is achieved by meeting or exceeding the needs and expectations of customers. A flow
chart is a valuable tool used for CQI. Flow charts are pictorial representations that show the
sequential order of actions performed in order to complete a particular task.1 An example of a
flow chart may be seen below.2

This flow chart is from an article in the International Journal of Design, entitled Thinking
beyond the Cure: A Case for Human-Centered Design in Cancer Care.2 The content of the article
covers quick ethnographic research of cancer patients undergoing curative radiotherapy
treatment. The purpose of the research was to explore how a human-centered design (HCD)
could reduce or prevent situational anxiety for patients undergoing radiotherapy treatment. The
researchers observed the patients interactions with care providers, the technology, and the
environment in order to identify situational causes of patient anxiety during the course of
radiotherapy.2The goal of the researchers was to take a detailed look at the processes involved
with radiotherapy in order to identify sources of situational anxiety and evaluate the possible
benefits of a HCD approach to current cancer care practices.
The purpose of the flow chart during this research was to identify the role of the patient
and each staff member involved in the radiotherapy treatment process, noting the technologies

involved as well as the importance of each technology to the service being provided. The flow
chart helped the researchers to understand the process of radiotherapy from start to finish.
Through the mapping of the flow chart and paying close attention to the technologies
used, it became evident to researchers that immobilization devices, although a necessary for
accurate delivery of radiotherapy, often caused situational anxiety for patients. The researchers
noted that measures were taken to counter act anxiety such as making alterations to treatment
masks or giving the patients panic buttons that they could press to let the staff know that
something was wrong and the radiation should be stopped. The researchers proposed a more
HCD and recommended potential changes such as allowing the patient to connect with the
immobilization device in a more comfortable setting or employment of interventions aimed at
distracting patients from their discomfort and anxiety brought on by immobilization devices.
References
1. Lenards N. Continuous Quality Improvement. [Softchalk]. La Crosse, WI: UW-L Medical
Dosimetry Program; 2011.
2. Mullaney T, Pettersson H, Nyholm T, Stolterman E. Thinking beyond the cure: a case for
human-centered design in cancer care. Int J Des. 2012;6(3):27-39.
http://www.ijdesign.org/ojs/index.php/IJDesign/article/view/1076/525. Published December
31, 2012. Accessed December 2, 2015.