How do you identify and map a workflow for improvement?
A workflow may be a good candidate when staff repeatedly request status updates, several calls are needed to find the right person, information is entered in multiple systems, teams use separate spreadsheets, ownership changes across shifts, or leaders cannot measure completion.
These signals often reflect a process that relies heavily on individuals to carry its coordination — not poor performance by the people involved.
Workflow mapping creates a shared view of what actually happens. AHRQ recommends examining both clinical and administrative workflows when planning and implementing health information technology. [1]
A useful current-state map should show:
✓The trigger, intended endpoint, and meaning of "complete"
✓The people, tasks, decisions, information, and systems involved
✓How work and responsibility move between participants
✓Expected timing, dependencies, and escalation
✓Workarounds and what happens when the expected path changes
Start with the people who do the work. Frontline participants can explain how the intended process operates in practice. Following one recent case may reveal workarounds and exceptions that do not appear in policy. AHRQ also provides practical workflow-mapping guidance. [4]
How do you optimize a clinical workflow?
Clinical workflow optimization works best as a continuous improvement process.
1
Choose one defined workflow
Begin with a process such as consult response, discharge coordination, or critical-result communication — not a goal as broad as "improve communication."
2
Define the outcome and baseline
Agree on what completion means and how the current process performs.
3
Map the current state
Document participants, steps, systems, timing, handoffs, exceptions, and workarounds.
4
Identify effort and uncertainty
Look for duplicate entry, unclear ownership, repeated follow-up, excessive alerts, disconnected systems, and unnecessary steps.
5
Design the future state
Decide what should remain, change, become standardized, or receive technology support.
6
Test with the people who use it
Pilot the new process during real work and gather feedback.
7
Measure and refine
Adjust roles, timing, routing, alerts, and escalation based on results and experience — then begin the cycle again.
ASTP/ONC recommends continued optimization that incorporates feedback from clinicians, other users, and patients. [2]
Standardization should define required steps, roles, information, timing, escalation, and completion while allowing for clinical judgment, patient-specific needs, alternate coverage, and exceptions.
How can technology support clinical workflows?
Technology is most useful when aligned with a clear process. EHRs maintain the clinical record; secure messaging supports information exchange; directories identify responsible people; integrations connect systems; analytics reveal patterns; and workflow platforms organize ownership, timing, routing, status, and escalation.
Automation can initiate notifications, assign tasks, route requests, update status, or escalate after a defined interval. Before automating, confirm that triggers, ownership, exceptions, and failure responses are clear. AI may also summarize information, suggest routing, or flag possible delays, with appropriate verification and oversight.
Clinical decision-support information should be clear, well organized, and available within the provider's workflow so it can support timely decisions. [3]
Technology coordinates the process
Routing information, assigning tasks, tracking time, and surfacing status.
People provide the judgment
Clinicians remain responsible for interpretation and care decisions.
Cross-organization workflows may involve different systems and definitions of responsibility. Technology should securely connect participants, preserve context, and clarify the expected handoff and outcome.
How should organizations measure and evaluate workflow technology?
Measures should reflect the workflow's intended purpose and what the redesigned process can reasonably influence.
Timing
Time to acknowledgment, first response, next stage, and completion
Reliability
Completion, escalation, overdue steps, and manual follow-up
Efficiency
Handoffs, duplicate steps, messages, manual entry, and staff coordination time
Quality
Required information, appropriate escalation, process adherence, and documented outcome
Experience
Clinician, staff, and patient experience; confidence in workflow status
Look for configurable steps, role-based ownership, response windows, routing, escalation, secure communication, status visibility, audit history, reporting, integrations, cross-organization participation, appropriate notifications, and implementation support.
Start with a specific use case and select measures tied directly to that process. Broad outcomes such as length of stay or readmissions may be important, but many factors beyond one workflow can influence them.
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