Central Community Hospital hired Susan Davis as the new manager to work in the health information management (HIM) department. One of the first items Susan reviewed was the workflow process for how documents were handled between the intake department and HIM. The intake department is responsible for assuring all documentation needed for a new admission to the hospital is received from the clinic that is admitting the patient. She noticed that the two departments were managing a lot of the same work, which created duplicate documents in patient charts. She noticed that intake would send documents to HIM that they (intake) already scanned. HIM would then see the documents come through, and scan them as well, but also created a copy to send to the utilization nurse who is responsible for ensuring that reimbursement authorizations are in place and managed. When Susan asked intake about why they sent the documents to HIM, the answer was "because that's how it has always been done." When thinking about other ways the situation could be handled, Susan came up with the following ideas:

• Have intake scan the documents into the EHR, and then hand the copy to the utilization review nurse, leaving HIM out of the process for this particular situation all together; or
• Once intake is done with the document, do not scan into the chart, rather hand it directly over to HIM, and continue with the rest of the process.

Real World Case Discussion Questions

1.What is the process Susan is examining?

2.What is the step called when Susan introduces the formal process of implementing a new change?

3.What type of analysis would Susan conduct before implementing the change?