Table 3. Open in new tab Example...

Diagnosis

Recommendation

Potential effort

Potential impact

Scope

Cascade?

Patients having difficulty opening some exam room doors; nurses unable to tell if these rooms are available

Remove door closers on exam room doors

Low

Moderate

Local

Individual physicians are not full time in a clinic/center and sometimes create individual processes that conflict with overall clinic/center processes

Develop strategies to integrate physicians more fully into overall standard clinic/center processes

High

Local

Could decrease effort involved in optimizing processes; could improve flexibility of staffing support across the clinic/center

Front desk staff using manual process to assist with complex test ordering; complaints and delays due to incomplete information and errors

Implement electronic ordering for complex laboratory tests

High

Global

Could assist with staff training and retention; could decrease delays related to information

Length of patient education appointments and volume of information presented can be overwhelming for patients

Develop/purchase patient education videos to complement nurse practitioner training

Low

Moderate

Local

Patients and informal caregivers have difficulty getting timely completion of paperwork; lack of clear chain of responsibility for paperwork completion

Develop Family Medical Leave Act and Disability paperwork tracking

Moderate

High

Global

Satisfaction levels of front desk staff; issues with staff retention

Identify and implement career growth pathways for front desk staff

High

Global

Could resolve additional issues with use of staff pool and training

Table 3.

Open in new tab

Example recommendations from SIOD projects

Diagnosis	Recommendation	Potential effort	Potential impact	Scope	Cascade?
Patients having difficulty opening some exam room doors; nurses unable to tell if these rooms are available	Remove door closers on exam room doors	Low	Moderate	Local	No
Individual physicians are not full time in a clinic/center and sometimes create individual processes that conflict with overall clinic/center processes	Develop strategies to integrate physicians more fully into overall standard clinic/center processes	High	High	Local	Could decrease effort involved in optimizing processes; could improve flexibility of staffing support across the clinic/center
Front desk staff using manual process to assist with complex test ordering; complaints and delays due to incomplete information and errors	Implement electronic ordering for complex laboratory tests	High	High	Global	Could assist with staff training and retention; could decrease delays related to information
Length of patient education appointments and volume of information presented can be overwhelming for patients	Develop/purchase patient education videos to complement nurse practitioner training	Low	Moderate	Local	No
Patients and informal caregivers have difficulty getting timely completion of paperwork; lack of clear chain of responsibility for paperwork completion	Develop Family Medical Leave Act and Disability paperwork tracking	Moderate	High	Global	No
Satisfaction levels of front desk staff; issues with staff retention	Identify and implement career growth pathways for front desk staff	High	High	Global	Could resolve additional issues with use of staff pool and training

Diagnosis	Recommendation	Potential effort	Potential impact	Scope	Cascade?
Patients having difficulty opening some exam room doors; nurses unable to tell if these rooms are available	Remove door closers on exam room doors	Low	Moderate	Local	No
Individual physicians are not full time in a clinic/center and sometimes create individual processes that conflict with overall clinic/center processes	Develop strategies to integrate physicians more fully into overall standard clinic/center processes	High	High	Local	Could decrease effort involved in optimizing processes; could improve flexibility of staffing support across the clinic/center
Front desk staff using manual process to assist with complex test ordering; complaints and delays due to incomplete information and errors	Implement electronic ordering for complex laboratory tests	High	High	Global	Could assist with staff training and retention; could decrease delays related to information
Length of patient education appointments and volume of information presented can be overwhelming for patients	Develop/purchase patient education videos to complement nurse practitioner training	Low	Moderate	Local	No
Patients and informal caregivers have difficulty getting timely completion of paperwork; lack of clear chain of responsibility for paperwork completion	Develop Family Medical Leave Act and Disability paperwork tracking	Moderate	High	Global	No
Satisfaction levels of front desk staff; issues with staff retention	Identify and implement career growth pathways for front desk staff	High	High	Global	Could resolve additional issues with use of staff pool and training

SIOD: Systematic Iterative Organizational Diagnostics.

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