Prepare a flowchart of the following medical appointment process at a Navy medical center.

Prepare appointment book.

Open appointment book.

Is the appointment on shore or aboard ship?

If aboard ship, tell patient to call xxx-xxxx by 1500 hours (3 P.M.) to make own appointment for next working day.

If on shore, issue next available appointment to patient.

Remind patient to call 24 hours in advance to confirm appointment.

Did patient call 24 hours in advance?

If no, cancel appointment and give appointment to new patient.

If yes, give patient confirmation number.

If yes, does patient show up for appointment?

If yes, mark appointment book “patient showed.”

If no, mark appointment book “failure: Patient did not show.”

If no, place standby patient in appointment.

If no, issue failure report to commanding officer.

Required

a. What is a defect in this process?

b. What does this flowchart indicate about possible sources of defects?

c. Can you recommend changes in the process to reduce defects?