The current state process map example for care

The current state process map example for care planning on the next slide may be used as ‘starting point’ for any team. Some tips: • Change the colour of a box by highlighting it, clicking on “Format” in the toolbar at the top, and selecting a new shape fill colour. • The arrows will stay connected to the boxes if you link them at the red dots. • Hold down the <shift> key while clicking on multiple boxes, then they can be moved as a unit.

Example Care Planning Process: Current State Could the patient be booked to see other team members as well as physician for care planning? Books a care Greets patient planning upon arrival appt Is there an opportunity to proactively identify and schedule patients? Fills in care plan Could another team member be involved here? Reviews care plan with patient MOA Reception Physician Could this be done at the time of booking? Confirms patient demographic Verifies patient attachment Checks patient’s ht/wt Rooms patient Greets patient Has this been completed within the last year? Is it necessary? Is there opportunity to build trust with the patient through conversation and asking what matters to him/her? Counsels Performs patient re. physical exam health goals Checks BP Who else could do this? Is there an opportunity to better prepare patients for care planning conversations? Signs care plan with patient Patient Leaves with care plan copy Will other team members from the clinic or PCN be involved in the patient’s care? If so, how can the patient introduce them in a way that shows confidence and trust? Makes referrals Reviews lab results Yes Lab results current ? Could this be done No in advance of the appointment? Gives patient lab req Completes chart Who will follow up with the patient to close the loop on referrals? Does the team have a plan to review progress made on care plan during subsequent visits (not just annually)?