Swim Lane

This web page accompanies “Using Process Mapping to Identify Patient Safety Hazards in Micro-Systems” in Quality and Safety in Healthcare. by John Grout

Mapping  Approach

Level detail

Hierarch ical

Multiple flows

Org. Struct.

Icons

Logic operators

Flow time

Information/Citations (links to acquire info)

Swim Lanes

 

Swim lane Process maps are very similar to flow charts except they very explicitly show the organization structure.  They differ only because they arrange the map on a table where the rows indicate the “who” does the process step.  Where the “who” can be specified as an individual, a department, or an organization. The advantage of this mapping approach is that process flows that change “lanes” indicate hand-offs. This is where lack of  coordination and communication can cause process problems.  It also shows who sees each part of the process.  Clear distinctions can be made between the back-office and those process steps where patient interactions occur.  It also can show that some healthcare processes may only be seen in their entirety by the patient.

The swim lane process map example below shows a portion of the process of a lumpectomy that my wife, Susan, experienced in 2001. She detected two errors in the process.  Error #1 occurred when the surgeon intended to employ a needle locator to identify the location of the tumor, but failed to forward an order to that effect to the hospital.   Susan identified the omission prior to surgery. No harm occurred. Error #2 was a typographic error on the pathology report indicating that the tumor was 1.6 mm diameter, when in fact it was 1.6 cm. A phone call to confirm the correction avoided any harm.

 

Process map continued

The level of detail on the example above is relatively low. Each consultation has its own process.  However, the capability exists to make swim lane process maps as detailed as flow charts.  All of the flow chart icons and logical operators are available swim lane maps (although not shown above).

There is no specific scheme in swim lanes that allows mapping  hierachical links.  Employing hierarchical maps would require devising a system  to identify hierarchical links.

Multiple flows can be easily included on swim lane maps; however, care should be taken to distinguish one flow from another. Normally these distinctions are accomplished using the text within the icons and along the arrows to clarify what type of flow is being represented.

[Process Mapping] [Flow Chart] [Top Down] [Swim Lane] [Value Stream]