What is it: An illustration of the sequence of activities that make up a process

1. Understanding the activities that constitute a process and the relationship among those activities
2. Providing a framework for further process analysis by ensuring that the list of activities is complete
3. Identifying opportunities to eliminate problems, add missing steps, and streamline work
How to draw it:
1. Decide where the process begins and ends
2. List all the activities in the process (usually left to right, top to bottom)
3. Arrange the activities in sequence, make sure to include all decision points
4. Draw arrows to clearly show the sequence of activities
5. Review the flowchart and answer these questions:
Where are the bottlenecks in your work flow?
Where can rework or redundant steps be eliminated?
Where can time be saved?
Example Serving customers in a restaurant process flow

Begin, end
Activity, task
Decision
??
Customer
Enters

Take Order
Take money and
give change

Give food to
customer

Say Thank
You!
Customer
leaves
restaurant
1. Understanding the activities that constitute a process and the relationship among those activities
2. Providing a framework for further process analysis by ensuring that the list of activities is complete
3. Identifying opportunities to eliminate problems, add missing steps, and streamline work
2. List all the activities in the process (usually left to right, top to bottom)
3. Arrange the activities in sequence, make sure to include all decision points

Delay
Food
Ready
Wait until
food is ready
No
Yes
ThinkReliability.com - Cause Map Template Copyright 2000
Flow Chart Template
Borrowed from ThinkReliability.com Cause Map Template

Notes to help you get started. These notes provide some assistance in using the MS Excel Flow Chart
template.

Open the Drawing Toolbar in Excel:
Click on View/Toolbars and click Drawing. It should appear at either the top or bottom inside the Excel
application. The Drawing Toolbar starts with the word Draw. There is an arrow next to Draw. Placing your
mouse cursor over any item on the Drawing Tool, without clicking on it, will display its function

Basic tools to create a flow chart: (Boxes and Lines)

Process or Activity Boxes -
Copying a Box
Making a flow chart is as easy as copying boxes, adding text and then adding connectors. You can copy
one of the boxes and make as many as you need. To copy a cause box click on the box so that the border
of the box turns to diagonal lines. Click anywhere on the diagonal lines to turn the border into dots. Once
the border of the box becomes dots, with the mouse still on the border area, right click the mouse to pull up
the copy menu on the screen. Select copy and left click the mouse. You can now paste as many copies of
the box as you need. If there is text in the box you can click the text and either type over it or delete it.
Making a New Box
Move your mouse over the Text Box on the Drawing Toolbar - the text box is a square with an 'A' and some
small lines in it. Left click on the Text Box, locate the mouse on the worksheet, and left click the mouse
again while holding down the left mouse button. You can now drag the box to any size you prefer.
Centering Text
The text in the box may not be centered. You can center the text by clicking on the box to create the
diagonal line border then double clicking the diagonal line border with the left mouse button to pull up a
format box. Click on the Alignment tab and change both the horizontal and vertical alignments to centered
and click OK.
Moving Boxes
By clicking on a cause box, creating either a diagonal line or dotted border, and holding down the left
mouse key you can move box on the worksheet. By clicking on the arrow to the right of Draw on the
Toolbar you can drag a dashed box around many cause boxes by using the left mouse button and holding it
down. You may then move all of them by grabbing the dotted border on any one of the boxes. Also, once
the box has a dotted border you can move it small amounts with the arrows on the keyboard.

Line Connectors -
Do not use either the line or the arrow that is displayed on the toolbar. There is a much easier way. Click
AutoShapes on the Toolbar, select connectors with the left mouse button so that the box of nine connectors
appears. Move your mouse to the gray horizontal bar at the top of the connector box and hold down your
left mouse button and drag the connector box to either the Toolbar at the top or bottom of your screen in
Excel - or simply drag it onto the worksheet - and let go of the mouse button. These are the line connectors
that are the easiest to use because they stay connected to the boxes even when you move the boxes
around. Use the connectors called either the Elbow Connector or the Elbow Arrow Connector. The names
pop up when you move the mouse over them without clicking on it. Remember if you decide to use the
arrow, it should point to the next step or activity.

Layering Level of detail - Multiple Worksheets
Two show high-medium-low level flow charts - break the boxes into varying levels of detail. Do a high level chart or
map forcing activity description of the process in 6 to 9 steps (boxes). Each box has its own set flow steps. On the top
toolbar click Insert/Worksheet command, right click. On the sheet1 tab at bottom, right click, choose Rename and give
it the activity description of the box it is flowing.

END





ThinkReliability Copyright 2001 modified
1/01/02





These notes provide some assistance in using the MS Excel Flow Chart
Click on View/Toolbars and click Drawing. It should appear at either the top or bottom inside the Excel
application. The Drawing Toolbar starts with the word Draw. There is an arrow next to Draw. Placing your
Making a flow chart is as easy as copying boxes, adding text and then adding connectors. You can copy
one of the boxes and make as many as you need. To copy a cause box click on the box so that the border
of the box turns to diagonal lines. Click anywhere on the diagonal lines to turn the border into dots. Once
the border of the box becomes dots, with the mouse still on the border area, right click the mouse to pull up
the copy menu on the screen. Select copy and left click the mouse. You can now paste as many copies of
the box as you need. If there is text in the box you can click the text and either type over it or delete it.
the text box is a square with an 'A' and some
small lines in it. Left click on the Text Box, locate the mouse on the worksheet, and left click the mouse
again while holding down the left mouse button. You can now drag the box to any size you prefer.
The text in the box may not be centered. You can center the text by clicking on the box to create the
diagonal line border then double clicking the diagonal line border with the left mouse button to pull up a
format box. Click on the Alignment tab and change both the horizontal and vertical alignments to centered
By clicking on a cause box, creating either a diagonal line or dotted border, and holding down the left
mouse key you can move box on the worksheet. By clicking on the arrow to the right of Draw on the
Toolbar you can drag a dashed box around many cause boxes by using the left mouse button and holding it
down. You may then move all of them by grabbing the dotted border on any one of the boxes. Also, once
Do not use either the line or the arrow that is displayed on the toolbar. There is a much easier way. Click
AutoShapes on the Toolbar, select connectors with the left mouse button so that the box of nine connectors
appears. Move your mouse to the gray horizontal bar at the top of the connector box and hold down your
left mouse button and drag the connector box to either the Toolbar at the top or bottom of your screen in
and let go of the mouse button. These are the line connectors
that are the easiest to use because they stay connected to the boxes even when you move the boxes
around. Use the connectors called either the Elbow Connector or the Elbow Arrow Connector. The names
pop up when you move the mouse over them without clicking on it. Remember if you decide to use the
break the boxes into varying levels of detail. Do a high level chart or
map forcing activity description of the process in 6 to 9 steps (boxes). Each box has its own set flow steps. On the top
toolbar click Insert/Worksheet command, right click. On the sheet1 tab at bottom, right click, choose Rename and give
Name of
Activity goes in
Boxes
Drag and
position boxes:
Left to right, to
Use AutoShape
Connectors
Move or Delete
the boxes in the
way
Size box to add more
text. Place mouse
over corner, left click
then drag. Go ahead,
try it
Decision&
Start: copy
symbol and
Start or
End
Decision
or Choice
Delay
point
See
Instructions
Click on box
and type to add
text
Click on a box
and...
to hide textbox
lines - right
click box line,
format,
color/lines,
none
...hold down the
mouse button
to move it
around
if you boo-boo,
click undo
'curved' arrow
Add flow
choice on line
Pretty cool,
huh?
Add text
box here
Make sure
you have the
drawing tool
Starting
Point
yes
no
MRI
Scanning
45-60 min 4 Opt machines
Discharge Patient
Make Film
10 min

View, Interpret
Dictate
30 min
Wait to be seen:
__ mins.
Screen Patient:
~ 20min
Note: This flow is horizontal. Since cycle time
was important, the processing time at each step
was incuded in the box. This flow even
indicates the rate-restricing step (bottleneck)
which is Scanning.
Discharge Patient
View, Interpret
Transcibe
7 min
Prelim Dictation Adj
or Signed
7 min
Final Signed
__% Adj 30 min
Flow Chart Title and Revision Date
-- START --
PSC addressographs
and attaches charge
sheet, supply sheet
and blank CSR to
chart. 1
Arrive (log-in) patient in
CARE. 2
RN completes specified fields
on charge sheet (date of
service/OP) 3
Physician and/or clinician sees
patient and marks charge ticket
with the following: Reason for
visit, E&M visit, and any
procedures pertinent to the
visit. Progress notes are to be
dictated following encounter
(early dictation is preferred).
Nurse marks E&M technical
level. 4
Top copy turned in right after visit.
No
Late Dictation
Physicians copy will be used
for late dictation (2nd copy
different color) and placed in
the drop off box when
completed.
PSC tracks down missing info
Coder picks up and codes off
marked sheet. 8
Is there a
properly
"marked" top
copy ? 6
End of Day 1
PSC reconciles
all sheets with
Arrival log. 7
Note: A single electronic input
screen will eventually be developed
by IS to which load codes both in
IDX and CARE. Person doing entry
TBD. Until then the codes/charges
will be entered in CARE and IDX
separately. 9
PSC reviews ticket for
missing fields 5
Back (Physician's) copy if there are changes
Yes
Note: this flows vertically. To
help people follow the flow and
unique number is placed in
each box for referencing.
PSC reconciles a
Technical and
Professional charge for
each patient. 10
Flow Chart Title and Revision Date
DAY 1
Day of Service
Late Dictation
Physicians copy will be used
for late dictation (2nd copy -
different color) and placed in
the drop off box when
completed. 12