Create a swim lane process map $($with draw.io$)$ for this story with a swim lane for each of the staff role that interacts with the patient. Include cycle times $($durations$)$ for each step. Note whether it was a Value Added $($VA$)$ or Non$-$Value added $($NVA$)$ step.

Create a top$-$level Value Stream Map to include each of the mentioned $15$ steps with process times for each step, determine which of the above$-$noted steps are VA or NVA, and indicate the total VA time $($aka PCE $$ Process Cycle Efficiency $=(($total VA time $/$ total time$)$ x $100).$ This compares the overall lead time from process steps $1$ to $1$

Private Practice Case Study for Module $2$: Essential Tools for Quality Improvement Background Summary: A family medicine practice, with a history of over two decades at the same location, was running with a full team, including a Doctor, a Physician$$s Assistant $($PA$),$ Medical Assistants $($MA$),$ Office Managers, and Clerks. Though a significant part of the staff had been with the practice for many years, the practice faced challenges. With nearly $8,700$ patient visits the prior year, they had shifted from paper to an electronic health record $($EHR$)$ system due to the Affordable Care Act $($ACA$)$ requirements, which proved to be a major transition. The practice struggled with the accuracy of their EHR system and lacked process$-$oriented operations. A Lean Six Sigma consultant was called in$,$ emphasizing that the practice had issues with data management, process efficiency, and possibly its organizational culture. "A Really, Really Bad Day at the Office...$$ Any yellow highlights sections are issues that affect the patient. Any bolded text represents the job titles of those working in the Doctor$$s office. Summary of the case study: $1.$ One of the two Medical Assistants $($MA$)$ came in to find a packed schedule, unaware of back$-$to$-$back new patients. The day worsened as the other MA called in sick, and the Doctor was late, causing delays from the start. $2.$ The first patient was kept waiting due to the Doctor's delay. A patient without an appointment was unhappy with the service and was allowed to skip ahead in line, frustrating other waiting patients. $3.$ The solo MA faced multiple issues: she forgot supplies for a room, missed recording vitals, was criticized by both the Doctor and the PA$,$ and made an x$-$ray error. $4.$ The Doctor's stress increased with the growing patient backlog. With an essential lunch meeting, the Doctor had to leave some patients to the PA$,$ risking further complaints. He even made an incorrect EHR entry and nearly prescribed the wrong medication to a patient. $5.$ The Check$-$Out Clerk faced complaints from patients waiting for extended periods, made an error in providing a referral, and was emotionally affected by personal issues. $6.$ The Office Manager juggled problems, including wrong deliveries and staff$-$related concerns, alongside criticism from the Doctor over the day's disorganization. $7.$ The Revenue Cycle Management Clerk identified documentation errors, faced challenges with inadequate coding details, and had to frequently "down$-$code" due to insurance denials. $8.$ The tiring day ended late, leaving the staff fatigued and discontented. Both the MA and PA considered leaving their positions at the practice. $9.$ The Doctor contemplated joining an accountable care organization, though hesitant about losing his independence. An accountable care organization $($ACO$)$ is a healthcare organization that brings together a group of coordinated health care practitioners, such as doctors, hospitals, and other providers, to deliver high$-$quality and coordinated care to a designated group of patients. $10.$ Patients were also not very happy at all today with the service they received and the excessive wait times. Here's the $15$ steps an average patient goes through at this practice and what the average duration times were for each step: $1.$ Arrival and Check$-$in: Duration: $15$ minutes The patient spends time waiting in line, searching for necessary documents, and handling paperwork provided by the receptionist. $2.$ Filling Out Paperwork: Duration: $25$ minutes Due to unclear instructions or lengthy forms, the patient takes an extended time to fill out or update their information. $3.$ Additional Waiting to get into an exam room after filing out the paperwork: Duration: $45$ minutes The waiting area is crowded, and the office is running behind schedule, resulting in a prolonged wait. $4.$ Patient is moved to the exam room: Duration: $1$ minute $5.$ Additional Waiting time in the exam room before anyone comes in to see the patient: Duration: $30$ minutes $6.$ Patient vitals checked in the exam room: Duration: $10$ minutes The medical assistant is juggling multiple tasks and is not immediately available. When they do arrive, the equipment might need recalibration or is temporarily nonfunctional. $7.$ Additional Waiting for the doctor to come in the exam room to see the patient: Duration: $20$ minutes The Doctor is backed