Emergency room Construction Document
Access Management 1 Table of Contents Identify the general process and milestones... 2 Stakeholders... 3 Experience design... 3 Manage Stakeholders... 4 Identify Activities, what Stakeholders can do... 6 Identify Actions, Activities, Contexts and Data... 8 Nurse... 8 Doctor... 9 Patient...10 Processes Description... 11 Main facts in the Process Construction... 14 Data Model... 14 Heritage configuration...15 Constructors...18 Templates...18 Triggers and Conditional activity...19
Access Management 2 The following example is a simplified version of an Emergency room, where a patient arrives with a particular condition and the people involved in the case will work to make the patient feel better. This Emergency room does not consider admitting someone in the hospital. This would be handled sending the patient in an ambulance to another clinic. Scope: the process starts when a patient arrives to the ER, and ends when a treatment is in place to heal the patient. The Emergency room process depicts an example of the use of Bizagi 11 features and options to take advantage of the Experience Design concept, to best address unstructured processes. Unstructured processes are those which you may catalog as highly unpredictable or dynamic, mainly because these processes may involve at some point a very large number of possible alternatives in the workflow. It represents how the Stakeholders (knowledge workers) are able to make decisions to define the flow of a case, that cannot be predicted beforehand. The scope of the Emergency room case is the attendance of a patient. Through Experience Design you will be able to make the most of: Empowering knowledge workers, presenting a personalized user experience, and using contextualized BPM capabilities, among others. Note: this is not a complete emergency room process; it would require more extensive definitions. Identify the general process and milestones Identify the general process, or happy path, providing a high level business description of what will be automated. Identify the most common outcomes (in this first stage do not include exceptions) and the stages of the case, or milestones. The milestones of the Bizagi ER are: - Triage and registration - Examination - Tests - Treatment - Transfer patient to clinic for surgery
Access Management 3 Not all milestones will have to be reached in a case instance. In fact, several are mutually exclusive. Some may be revocable: even when the milestone has been reached, the case stakeholders can decide that on second thoughts it is not reached after all. Stakeholders Bizagi 11 presents a Work portal which allows knowledge workers to make informed decisions, such as when to start a process or update data, boosting agility and productivity. Various stakeholders can be associated with the case. However, each stakeholder may directly or indirectly influence the case. Not all stakeholders listed have to be involved with every instance of the case. Identifying Stakeholders is important to be able to personalize their experience. - Doctor - Nurse External Stakeholders (usually are evaluated to be or not to be included as part of the automation) - Patient Experience design In Bizagi Studio each Stakeholder has their experience designed in the Experience Designer menu. Each tab (Actions, My Stuff, Search) has a definition according to each user s available options. Keep in mind that to enable a group to be available in My Stuff section, the Stakeholder must have a Direct or indirect collection to an entity. Thus, the Nurse for instance, has a collection to Medical Equipment. That way, each Nurse will own one or more equipment, and will be able to view them in the Work portal, and manage them if there are actions available to manage them.
Access Management 4 Manage Stakeholders As you download this template, make sure you have created at least one user per Stakeholder and have configured them in the Admin option of the Work Portal. If you don`t have one user per Stakeholder, this template will not work. Go to the Admin option and for each Stakeholder create a new record, by creating a new user and filling in all additional required information.
Access Management 5 Keep in mind that to manage Stakeholders in the Work Portal we have already defined the management forms for them. These forms will display what information to be shown and requested when configuring a user as a Stakeholder. In Studio we defined a Display form that depicts the columns of the Stakeholder s main view. And an Add and Edit form, that relate how a Stakeholder record is added and edited.
Access Management 6 Identify Activities, what Stakeholders can do This involves the activities the stakeholders can initiate and other case related operations they can perform, categorizing their allowed interactions with the Work that will be enabled for them. Defining if Activities are mandatory under certain circumstances or are available but executed at the Stakeholder s discretion will help categorize an activity as an Action available as part of an unstructured process. Many activities in a case are not always available for execution. Only when certain milestones are reached in the case or specific conditions are met, will the activity be applicable. Activities can be withdrawn: when they are no longer relevant, they should not be presented to stakeholders. Stakeholder Activity description When can this action/activity be performed Comments Nurse Patient registration When in shift, as a The nurse searches and Triage patient arrives for a patient and then includes a date and time of arrival Choose Triage When performing a category triage
Access Management 7 Send a Patient to surgery Update Patient s information When performing a triage Anytime Monitor health In night shifts Monitor blood pressure and other Doctor View / manage medical equipment Examine patients: Very urgent, urgent and standard Anytime When patients are in the waiting room and doctor is someone who attends patients Request laboratory or radiology exams Review exams Take blood sample Perform radiology procedure Send to surgery View medical equipment When examining patients When patients have been sent for exams When examining patients and when reviewing exams Anytime Exams should be updated automatically if one or more are included in the supported exams list Only available when all exams have been performed
Access Management 8 Send equipment to repair Anytime Several pieces of equipment can be sent at once Patient View Exams, Triage and Doctors Search Doctors Anytime Anytime Identify Actions, Activities, Contexts and Data Nurse Activity description Context Availability Action / Activity Patient When in shift, as Via Search for Action: Start Triage to registration and a patient arrives patients, always launch Emergency Triage available process Choose Triage When Mandatory Activity: Triage category performing the triage Send a Patient to When Mandatory Activity: Triage surgery performing a triage Update Patient s Always without At discretion Action: Update info information the need of being in a particular case
Access Management 9 Monitor health In night shifts At discretion Collection in My Stuff Action: Add monitoring / Add collection item: View allocated Always without Through the Collection in My stuff equipment the need of data records in being in a My Stuff particular case Data description Context Availability Action / Activity Patients Always Via Search for patients, Action: Start Triage to launch Emergency process Medical equipment Always Always available Health monitoring In night shifts Mandatory Activity: Add monitoring Doctor Activity description Context Action / Activity Activity description Examine patients When patients Mandatory Activity: Examine patient reviewing triage are in the level: Very waiting room urgent, urgent and doctor is and standard someone who attends patients
Access Management 10 Request When examining At discretion Action within Examine laboratory or patients patient radiology exams Review exams When requested Mandatory Activity: Review exams exams have been finished Take blood sample Perform radiology procedure When allocated Mandatory Activity: Take blood sample within Blood test process When allocated Mandatory Activity: Perform radiology within Radiology process Send to surgery When examining At discretion Activity within Examine patients and patient when reviewing exams Activity within Review exams Repair equipment Anytime At discretion Batch action in My Stuff Data description Context Availability Action / Activity Patients Always Via Search for patients, Action: Start Triage to launch Emergency process Medical equipment Always Always available Action: Start a repair process including one or more equipments Patient
Access Management 11 Data description Context Availability Action / Activity Doctors, Exams, Always Via My Stuff, None Triage only to view Processes Description After reviewing the actions available, we can create the structure of a core process and processes that will be launched via Actions to support the case structure. The process starts with a patient arriving at the ER. A nurse examines the Patient and determines the scale of the emergency. The patient continues to a medical examination by a doctor, or is sent to surgery. The doctor can request the exams needed to identify the illness. The requested exam s processes are launched, as part of the ER case. As all exams are finished, the Review Exams activity is enabled. The patient can be dismissed after the exams review or sent to surgery. Main process: Triage Exams processes (supporting processes for unstructured management):
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Access Management 14 Main facts in the Process Construction Data Model The process entity of the Triage process is Triage which has all the attributes and relationships necessary to save main case information.
Access Management 15 There are three Stakeholders created, that have their Experience designed to give a unique Work portal for each one: Doctor Patient Nurse. Heritage configuration Several process entities are supporting the case, that make part of the Medical exams available. Medical exams are built using a Hierarchical model, that allow us to use the polymorphic launcher in the Examine Patient activity.
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Access Management 18 Constructors TO be able to display the Polymorphic launcher in the Work portal, each of the supporting exams processes need a Constructor defined. That is, a definition of how a record of each entity is built. For this template we used a processes for all of them. Thus, a constructor is defined for: Bilirubin, Blood chemistry, Tomography, Ultrasound and X-ray. In Bizagi Studio the Constructor wizard was used, and a process was defined for each one. Templates When browsing over data, either regarding results of data searches or lists of information which are part of My stuff, you may customize the information displayed for these resulting records. By default, Bizagi uses a basic template that chooses random attributes of the entity to which a record belongs to.
Access Management 19 We have defined data templates for the most relvant entities: Patient, Doctor, each of the Exams entities and Triage. Triggers and Conditional activity Conditional activities are used in processes to enable of disable activities according to a data condition in the process. In this template, we use the Review Exams Conditional activity: When all exams are finished, the Review exams activity should be enabled, but not before. The condition to enable or disable the conditional activity is set in the fourth step of the process wizard, Define Expressions, as show below.
Access Management 20 To set the Triage.Examsready attribute to true or false and thus enable or disable the activity, we use a Trigger.
Access Management 21 First, we use an expression at the end of all Exams processes, stating they are finished. When each of them is finished, the Trigger is launched and analyzed: If the exam is indeed finished, the Trigger performs an expression Event to review if all related Exams of the Triage case have been finished. If at least one of them is not finished, the Triage.Examsready attribute will remain in false.
Access Management 22 However, as soon as they are all finished, the Triage.Examsready attribute will be true and the Review exams conditional activity is enabled and allocated to the doctor.