Workflow, loosely defined, is the set of tasks—grouped chronologically into processes—and the set of people or resources needed for those tasks, that are necessary to accomplish a given goal. An organization’s workflow is comprised of the set of processes it needs to accomplish, the set of people or other resources available to perform those processes, and the interactions among them. Consider the following scenario:
These same methods that an organization uses to get work done, however, can begin to show stress under trying circumstances. When the ward is full and it takes 12 hours for a room to be readied for the next patient, that impact is felt throughout the organization. When the number of small interruptions outweighs the amount of planned work done in a given hour, that impact is felt in slower progress, lower job satisfaction, and potentially lower quality of care. In many situations, it is very clear to all what needs to get done. Where organizations differ is in how they do it. The examination of how an organization accomplishes its tasks often concerns the organizations’ workflow.
In health care, as in other industries, some workflows are designed, while others arise organically and evolve. The systems and methods by which organizations accomplish specific goals differ dramatically. Some organizational workflows seem more straightforward than others. Most often, when workflow processes are looked at in isolation, the processes appear quite logical (and even efficient) in acting to accomplish the end goal. It is in the interaction among the processes that complexities arise. Some of these interactions hide conflicts in the priorities of different roles in an organization, for example, what the nursing team is accountable to versus the physician team and its schedule. Organizations also adapt workflows to suit the evolving environment. Over time, reflecting on organizational workflows may show that some processes are no longer necessary, or can be updated and optimized.