Process mapping and the integration of care

INTRODUCTION: The main objective of this work is to show how process mapping may contribute to the improvement of intra- and inter-organizational integration of care. THEORY AND METHODS: Under logic of service integration, quality of care depends not only on how the internal processes are implemented, but also on the quality of the transitions of care with external entities. We conducted a case study on a health centre located in the Centre Region of Portugal. Data was collected during the first semester of 2009. Petri nets were used as a modeling tool. RESULTS: We mapped eleven processes involving a patient directly. The informality of many of the processes became evident. Activities are guided by formalisms imposed by law and by the good practices of professionals. Some processes are not normalized and represented in the computerized information system. The media most used to communicate with other entities are the phone and paper. Under the RNCCI (Rede Nacional de Cuidados Integrados e Continuados—National Network for Integrated Care), the information is all organized in an integrated manner, and the processes are support by a customized, nation-wide, web-based information system. However, this platform is not integrated with the other applications in use. CONCLUSIONS AND DISCUSSION: We have demonstrated the viability and the benefits of process mapping techniques in the context of a Health Centre. It allowed to identify and understand the ‘what’, ‘why’, ‘when’, ‘where’, ‘who’ of each process, sub-process, task and activity and to develop graphical views of the processes.