CHL Workflow and Process Design 4 — Questions and Answers
Question 1: A healthcare organization is redesigning its prior authorization workflow. After mapping the current state, the team finds 22 steps, of which only 5 add value. What metric describes this finding?
- Process cycle efficiency (Correct answer)
- Takt time
- Defects per million opportunities
- Mean time between failures
Correct answer: Process cycle efficiency
Process cycle efficiency (value-added time ÷ total lead time) measures the proportion of process steps or time that is truly value-adding, exposing waste.
Question 2: In designing a new patient intake process, the team calculates 'takt time.' What does takt time represent?
- The average time a patient spends in the waiting room
- The rate at which patients arrive compared to available capacity
- The time available to complete one unit of work to meet customer demand (Correct answer)
- The maximum processing speed of the slowest workstation
Correct answer: The time available to complete one unit of work to meet customer demand
Takt time = available production time ÷ customer demand rate; it sets the pace at which the process must operate to satisfy demand without overproducing.
Question 3: A hospital implements a 'bedside report' process where nurses hand off shift information at the patient's bedside rather than at the nursing station. This redesign PRIMARILY reduces which waste?
- Overproduction
- Defects
- Transportation and excess information handling (Correct answer)
- Overprocessing
Correct answer: Transportation and excess information handling
Bedside reporting eliminates redundant travel to the nursing station and reduces information loss during handoffs, addressing transportation and motion waste.
Question 4: Which of the following BEST describes a 'future state' value stream map?
- A diagram of the current process with waste highlighted in red
- An ideal process map created without constraints to inspire innovation
- A redesigned workflow showing improvements after waste elimination (Correct answer)
- A statistical model predicting future patient volumes
Correct answer: A redesigned workflow showing improvements after waste elimination
The future state map depicts the redesigned process after agreed-upon improvements are implemented, serving as the actionable target for the improvement team.
Question 5: A CHL is applying process design principles to reduce duplicate data entry in the EHR. Eliminating this duplication addresses which category of Lean waste?
- Waiting
- Defects
- Overprocessing (Correct answer)
- Inventory
Correct answer: Overprocessing
Entering the same data more than once constitutes overprocessing — doing more work than the output requires — and is a direct form of Lean waste.
Question 6: When a process redesign team uses 'mistake proofing' to prevent wrong-site surgery, the MOST effective level of error prevention is:
- Warning the surgeon verbally before incision
- Adding a checklist reminder to the operative note
- Designing a physical mechanism that makes the wrong action impossible (Correct answer)
- Posting a sign in the operating room about wrong-site events
Correct answer: Designing a physical mechanism that makes the wrong action impossible
The highest level of poka-yoke eliminates the possibility of error through design (e.g., a marking protocol + time-out that must physically occur), rather than relying on warnings.
Question 7: A healthcare leader is evaluating two redesigned workflows using a decision matrix. The matrix assigns weighted scores to criteria such as patient safety, cost, and staff acceptance. This tool is MOST useful for:
- Identifying the root cause of a problem
- Prioritizing and selecting among competing solutions objectively (Correct answer)
- Mapping the sequence of steps in the new process
- Measuring process variation after implementation
Correct answer: Prioritizing and selecting among competing solutions objectively
A weighted decision matrix quantifies trade-offs between options by scoring each against criteria and multiplying by importance weights, enabling objective selection.
CHL Workflow and Process Design 4
A healthcare organization is redesigning its prior authorization workflow.
After mapping the current state, the team finds 22 steps, of which only 5 add value.
What metric describes this finding?