CHL Workflow and Process Design 5 — Questions and Answers
Question 1: A healthcare organization wants to sustain process improvements after a Lean project concludes. Which tool is MOST effective for ensuring the new standard is maintained?
- Gantt chart
- Standard work documentation and visual management (Correct answer)
- Affinity diagram
- Regression analysis
Correct answer: Standard work documentation and visual management
Standard work documentation paired with visual management (e.g., visual cues, posted workflows) embeds the new process into daily operations and makes deviations immediately visible.
Question 2: A clinical team redesigns their medication reconciliation workflow and implements the change. Three months later, compliance has dropped back to old patterns. This phenomenon is known as:
- Process entropy (Correct answer)
- Regression to the mean
- Sustainability gap
- Change fatigue
Correct answer: Process entropy
Process entropy refers to the natural tendency of systems and behaviors to revert toward disorder or previous states without active control mechanisms in place.
Question 3: In healthcare workflow design, 'load leveling' (Heijunka) aims to:
- Assign the highest workload to the most experienced staff
- Distribute work evenly over time to prevent peaks and idle periods (Correct answer)
- Prioritize urgent cases over routine ones at all times
- Reduce the total number of staff needed in a department
Correct answer: Distribute work evenly over time to prevent peaks and idle periods
Heijunka smooths production volume and variety across a work period, preventing feast-or-famine cycles that lead to overburden or underutilization.
Question 4: A process improvement team is conducting a Gemba walk. The PRIMARY purpose of a Gemba walk is to:
- Audit staff compliance with policies from the administrative office
- Observe the actual work environment and processes where they occur (Correct answer)
- Present improvement proposals to frontline staff for feedback
- Conduct time-motion studies using remote video analysis
Correct answer: Observe the actual work environment and processes where they occur
A Gemba walk involves going to the actual place of work ('Gemba' means 'real place') to observe processes firsthand, gather data, and identify waste not visible from reports.
Question 5: Which of the following represents a 'pull' signal in a healthcare kanban system?
- A standing order to reorder supplies on the first of every month
- A visual card or bin that signals replenishment only when stock is consumed (Correct answer)
- A daily manager report listing all supply levels in the unit
- A purchase order automatically generated by the EHR at set intervals
Correct answer: A visual card or bin that signals replenishment only when stock is consumed
A kanban card or empty bin acts as a pull signal, triggering replenishment only when actual consumption creates need, preventing overstock and shortages.
Question 6: A CHL is redesigning patient flow using the Theory of Constraints. After identifying the constraint (bottleneck), the next step is to:
- Eliminate all non-bottleneck steps immediately
- Subordinate all other processes to support the constraint's throughput (Correct answer)
- Add resources to every step in the process equally
- Move the constraint to a different department
Correct answer: Subordinate all other processes to support the constraint's throughput
The Theory of Constraints directs that once a bottleneck is identified, all other process steps must be subordinated to maximize the throughput of that constraint before adding resources.
Question 7: A process design team is using affinity diagrams to organize staff feedback collected during a workflow redesign project. Affinity diagrams are BEST used for:
- Quantifying the frequency of specific defect types
- Grouping large volumes of qualitative ideas into meaningful themes (Correct answer)
- Displaying the sequence of steps in a proposed new process
- Calculating the cost-benefit ratio of each improvement option
Correct answer: Grouping large volumes of qualitative ideas into meaningful themes
Affinity diagrams organize large sets of qualitative data (ideas, observations, complaints) by natural groupings, helping teams synthesize complex information into actionable themes.
CHL Workflow and Process Design 5
A healthcare organization wants to sustain process improvements after a Lean project concludes.
Which tool is MOST effective for ensuring the new standard is maintained?