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How SIPOC Diagrams Can Improve Clinical Processes

Clinical processes are complicated but essential to creating consistent, high-quality outcomes. With so many competing priorities for time and attention, it may be difficult to properly document every process. It may even seem that a process workflow diagram or standard operating procedure may be “overkill”. But good process documentation doesn’t have to be complicated.

A SIPOC is a simple tool that is part of the Six Sigma methodology which is often overlooked.  It is easy to implement and can be done on a whiteboard, a notepad, or a simple Microsoft table.. There is no need for a fancy Visio process flow or lengthy how-to guides. This blog’s goal is to give you a simple structure that can help you think more about your processes and better track results.

Let’s see how SIPOC diagrams can improve clinical processes.

What is a SIPOC Diagram?

A SIPOC is simply a table that identifies important elements of a process. Six Sigma practitioners often use SIPOC diagrams as an initial step at the beginning of a process improvement project.The goal of a SIPOC is to help identify gaps and put a simple structure to help understand and scope a process from start to finish. To do this the SIPOC summarizes the inputs and outputs of process steps in table form.. The acronym SIPOC stands for Suppliers, Inputs, Process, Outputs, and Customers which form the column headers at the top of a SIPOC diagram. Each column is defined here.

  • Supplier: this is the person, department, or tool which provides the inputs for the process step.
  • Input: all the materials, information, and other resources that you need to complete a step in the process.
  • Process: a list with structure steps that you need to use to convert inputs into outputs.
  • Outputs: all those documents, treatment services, or physical products resulting from the process step.
  • Customer: the person, department, or system receiving the outputs.

How will SIPOC help?

A SIPOC diagram is one form of a process map. This simple structure allows you to describe each task and goal in a process simply and quickly. It also establishes a quick view of who interacts with each step making it handy for everyone involved in the process to have a general overview of the steps they’re responsible for, see how their work impacts others, and who should be providing critical inputs to them. Unlike Visio process diagrams or standard operating procedures, stakeholders and process actors can quickly read a SIPOC diagram with little or no explanation. When you’re short on time and need to communicate actions simply SIPOC is the right tool to use.

SIPOC diagrams also focus attention on process questions that are most important to understanding and driving results. Who supplies inputs to the process? Who provides the materials, documents, or approval needed before work can begin?

  • What specifications are placed on the inputs? What resources are needed or provided by the suppliers?
  • What steps or activities are carried out to created value?
  • What process steps create products or services?
  • Who are the individuals or systems which receive the benefits of a process step?
  • What are the requirements of the customers of each process step? What ensures that the output is valuable?

How to complete a simple SIPOC?

Completing a SIPOC table is easy. To begin you will need to label a whiteboard, spreadsheet or notebook with 5 columns each column with one letter spelling out S-I-P-O-C. Here there are some steps you can follow first to start filling your table:

  • Step 1: Start with the Process by listing out each high-level process step from start to finish. Don’t worry about exceptions or decision points, just go through each step in the most common scenario. You can always add variations to a new iteration of the SIPOC as a follow-up. Also, keep it simple. The process steps are not meant to outline every task but rather be high-level actions.  Example: Check-In, Capture Vitals, Appointments, Prescription/Diagnosis, Check-Out, Billing, etc.
  • Step 2: Identify the Outputs of the process. List as many outputs as you can think of for completing a particular process step. Don’t focus on the outcome or what good or bad quality output looks like at this step. Be thorough and consider not just physical outputs but technology outputs as well.  For example, an output for checking in may be completed intake forms, insurance documentation, and basic medical history.
  • Step 3: Identify the Customers. Your customers are any person, group, or system who benefit from the process. These could be but are not necessarily people who will acquire your product or service. For example our example of checking in, the customers would be the Front Desk, Revenue Cycle Management, and Physician.
  • Step 4: List the Inputs of the process. Here you will write about all the items required for the process step to be completed correctly. For example, at check-in, sign-in sheets and blank forms are provided as inputs.
  • Step 5: Identify the Suppliers of the inputs. Suppliers can be individuals, teams, departments, or even tools that produce a particular input.  For example, at check-in the Front Desk supplies the forms, and the Patient supplies the information to complete the forms. Both are suppliers.

If you want to take your SIPOC to the next level, some optional columns and additions to this table can be very helpful:

  • Critical To Quality (CTQ): In this column, you will list everything that improves the quality of the process step. This may eliminate errors in the inputs or outputs, improve the speed of inputs or outputs, limit the number of stakeholders needed to complete a process step, etc.
  • Requirements: identify the needs of the customers or specific obligations required to be compliant with contractual or legal expectations.

Example

S I P O C
Key suppliers Product and services delivered by suppliers High-level steps of the process Product or services delivered to the customer Key internal or external customers
Patients

Front Desk

Sign-In Forms

Insurance Information

Basic Medical History

Check-In Completed Forms

Medical History Details Used for Diagnosis

Physician

Back Office

Patients

Nurse/Tech

Medical Form/Record

Patient Identification

Capture Vitals Captured Vitals In Medical Record Healthcare Provider
Patient

Physician

Medical Details & Symptoms Appointment Diagnosis

Followup Details

Updated Notes on Medical Record

Patient

Physician

Back Office

Insurance

Physician

Pharmacy

Medical History

Insurance

Medicine Available

Prescription/Treatment Followups

Health Outcomes

Patient

Physician

Insurance

Pharmacy

Patient Payment Information

Scheduling Info

Check-Out Copay Collected

Next Appointment Scheduled

Back Office
Back Office Services Rendered Details

Insurance Details

Copay Details

Billing Generated Bill

Insurance Submission

Full Payment

Patient

Insurance

Back Office

*See full table click here

If you have done this right, the SIPOC diagram gives you important clues about the levers you can pull to make a process better. It also tells you what you should be monitoring to know if the process is working at each stage. Lastly, your SIPOC helps you focus on the right audience. Rather than treating all stakeholders equally, you focus on the stakeholders who have the highest value to improving the process. In summary, don’t skip documenting the process, just simplify the documentation.

At GSC, we value your business, and we know that sometimes a new approach can be overwhelming. If you need help completing your SIPOC diagrams, contact us. We are here to help you.

Learn more about Golden Source Consultants’ Strategy and Business Process Services.

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