The current workflow process has worked well for the past $10$ years. The new CFO wants the DNFB to drop from

$750,000\mathrm{.}00.$ Coding is the only thing preventing the bill from being dropped within $3$ days. In addition, there are complaints from some of the new physicians on staff that they have to wait too long to get charts to dictate. They want to be able to dictate the discharge summary within $48$ hours after patient discharge. To satisfy the CFO and the physicians, you need to make changes. You need to speed up the process to get the codes entered into the system faster, as well as to get charts to the incomplete chart room quickly. To accomplish this, you need to reengineer the current workflow. The current process is as follows:

The patient is discharged and the chart is taken to the incomplete chart room.

The nurse reviews the chart for any missing information and completes any necessary paperwork.

The chart is then sent to the coder, who enters the codes for the discharge summary.

The coder then sends the completed discharge summary to the physician to review and sign.

The physician returns the signed discharge summary to the coder.

The coder then enters any necessary corrections to the discharge summary and sends it to the hospital administration.

The hospital administration then reviews the discharge summary for any necessary approvals and then sends it to the patient's insurance company.

The insurance company then reviews the discharge summary and sends any necessary payment to the hospital.

The hospital then sends any remaining paperwork to the patient.

The patient returns any remaining paperwork to the hospital. To reengineer the current workflow, you will need to identify the bottlenecks in the process and then eliminate or reduce them. The bottlenecks in this process are the coding and the time it takes to get the charts to the incomplete chart room. To eliminate or reduce these bottlenecks, you will need to:

Speed up the coding process by hiring more coders or by training existing staff to code faster.

Get the charts to the incomplete chart room faster by using a more efficient system for transporting the charts, such as an electronic system.

Reduce the time it takes to get the charts to the incomplete chart room by having the nurse review the chart for any missing information and complete any necessary paperwork before the chart is sent to the coder.

Reduce the time it takes to get the discharge summary to the physician by having the coder send the completed discharge summary to the physician electronically.

Reduce the time it takes to get the discharge summary back from the physician by having the physician return the signed discharge summary electronically.

Eliminate the need for the hospital administration to review the discharge summary for any necessary approvals by having the coder enter any necessary corrections to the discharge summary before sending it to the patient's insurance company.

Reduce the time it takes to get payment from the insurance company by having the hospital send any remaining paperwork to the patient electronically.

Reduce the time it takes for the patient to return any remaining paperwork by having the patient return it electronically. By reengineering the current workflow in this way, you should be able to speed up the process and get the codes entered into the system faster, as well as to get charts to the incomplete chart room quickly. This will allow the hospital to drop the DNFB within $3$ days and to satisfy the physicians' complaints about waiting too long to get charts to dictate. Here are some specific steps that can be taken to reengineer the current workflow:

Identify the bottlenecks: The first step is to identify the bottlenecks in the current workflow. This can be done by tracking the time it takes for each step in the process and identifying where the delays are occurring.

Eliminate or reduce bottlenecks: Once the bottlenecks have been identified, they need to be eliminated or reduced. This can be done by hiring more staff, investing in new technology, or streamlining the process in other ways.

Speed up the coding process: One of the bottlenecks in the current workflow is the time it takes to code the discharge summary. This can be speeded up by hiring more coders or by training existing staff to code faster.

Get charts to the incomplete chart room faster: Another bottleneck is the