Imagine you are the supervisor of the health informationmanagement (HIM) department in a large outpatient clinic. Thisdepartment manages patient records. Complaints about yourdepartment are becoming more frequent and intense than in the past.Some clinic employees have complained that the HIM department takestoo long to retrieve patient records. Others have expressed dismayover the rudeness of HIM staff. You decide to talk about theseproblems with employees throughout the clinic. The clinic'sreceptionists respond to you defensively. They tell you that theHIM staff won't answer the phone and they want some backup whenthey are busy with patients. You talk to the HIM staff and findtheir stories are just as negative. They say they are being chargedwith more responsibilities but have not additional help. They alsocomplain that the receptionist's transfers calls that they shouldbe handling. The clinic's nurses are also upset with the HIM staff;they claim the department does not help them locate patient charts,causing long wait times for patients. The clinic's physicians saythey cannot assume the additional tasks to alleviate the situationbecause their days are already so chaotic.

5. What improvement tool would you use to define the currentprocess for retrieving patient records?

6. You believe that cooperation between the clinic receptionistsand HIM staff would improve if phone responsibilities were moreclearly defined. To whom would you assign the tasks of definingroles and responsibilities?

7. After redesigning the record retrieval process, you want tomonitor the effectiveness of your action. What improvement toolwould you use to determine whether the number of complaints hasdecreased?