Clinical workflow is an established process describing a series of tasks, how they are accomplished, who completes them, in which sequence, and at what priority.

An efficient workflow is necessary to keep a practice running smoothly. Inefficiencies, redundancies, bottlenecks, and errors can have detrimental effects for both the practice and the patient, including the following:

• Slowing down processes—and progress
• Impeding task completion
• Reducing quality of care
• Increasing “unintended consequences”
• Precipitating poor outcomes

Analysis of workflow is utilized to improve the efficiency, safety, and reproducibility of patient care. Experts in healthcare process improvement are available who can guide organizations through the steps of process improvement. The following points, however, deserve consideration if a practice wishes to examine its own workflow and attempt to develop a more efficient process.

The first step is to identify an inefficient process. Challenges to efficiency can be found in several areas, including patient check-in, radiology registration, sterile processing, and surgical scheduling. Ideally, the most problematic area should be the area of first focus.

Before attempting to implement “solutions,” take time to truly understand the current state of the problematic process. Often this involves mapping the current steps a patient or provider must follow through the entire process. Consider using a flow diagram (Fig. 1) to outline the steps in the process from beginning to end.

When reviewing any process, invite all parties involved in the process to the review. This will include physicians, nurses, registrars, and technicians. All will have insights on the current problems and potential solutions.

Addressing the most problematic area first should allow the most notable improvement and will engage stakeholders to address other inefficiencies in the future.

Processes are never perfect and need to be revisited in time or with any significant change in technology or staffing. This is the process of continuous improvement.

Charles A. Goldfarb, MD, is a member of the AAOS Practice Management Committee.