Welcome back. We are nearing the end of this section about Workflow Redesign/Reengineering. Let's talk about the key takeaways from this section. What did we learn? First we learned about the importance of learning about workflow reengineering in healthcare. We said that it's important to learn about this because the cost of a badly engineered workflow and healthcare is very significant. It can actually cause harm to a patient. Healthcare being a very complex system, there are chances that we may not understand enough and engineer a very bad workflow. That's why it's important to learn about proper methods of reengineering in healthcare. We looked at the definitions of workflow, workflow reengineering, and we saw some examples of workflows. Then, we took a clinical scenario as a case study. We defined the problem and went through the Plan-Do-Study-Act cycle. While doing this, I hope you became a little familiar with some common tools that are used. For example, the Swimlane diagram to map all the workflow. The Fishbone diagram and the five whys method, to find the root cause of a problem. The Big Bang versus phased roll out with a pilot methods, to implement a redesigned workflow. We also, talked about the fact that when changing a part of the system would be very disruptive to the whole system, you'd probably go with a big bang approach. You take a phased roll out with the pilot approach. When you want to learn from your mistakes, and you have the flexibility of starting your reengineered workflow, in a contained environment. Next, we talked about the adaptation of the Agile methodology in healthcare reengineering. Finally, we said that to achieve the Agile methodology in healthcare workflow reengineering, we need a very flexible information system. So, that we can learn from the mistakes that we're doing in our pilot. We can change the information system without a lot of investment or waste of time, money, or other resources. Finally, build a production system which really works for its intended effect. Taking a step back, we also talked about what are the guiding principles and the most important that we should always keep in mind is that, why are we doing a particular workflow reengineering. We always have to measure against the Triple aim. I know there is some talk about a full time now but for now let's stick with the Triple aim. That was given by the Institute of Healthcare Improvement. That is you should always ask; will my workflow improve the experience of care for the patient? Will it improve the health of the population? Or will it decrease the per capita cost of health care? Next, we talked about the 10 rules of redesign, which was given to us by the Institute of Medicine now called the National Academy of Medicine. We also, saw how the five rights of clinical decision support, is applicable in workflow reengineering in healthcare. I hope, you are more or less familiar with this subjects now. Before I let you go, to words of caution. Let's say that you have gone through this whole cycle, you have followed all the best practices and your workflow reengineering is working in a live clinical setting now and everybody is happy. Too often, we find that hard-won improvements are lost as attention shifts to other priorities and staff revert to the old way of doing things. everybody is busy. The old way of doing things it's sometimes very ingrained into people. So, it's very important to sustain change. How do we sustain change? First, capture, share, and celebrate short-term wins. Credit your team and frontline staff because they have suffered through so as to speak all these changes, and have invested their time, their resources and their expertise in making the workflow redesign work. If you look closely at the first, that is capture, share, and celebrate short-term wins, does it remind you about step six and Kotter's eight-step process for leading change? If it does can you tell me what is the next step in the eight step process? Well, it is to sustain acceleration. Press harder after the first success, you're increasing credibility can improve systems, structures, and policies. Now you can change the word. The second word of caution. When you're doing anything in healthcare related to data information, information systems, you will be exposed to a lot of healthcare-related data. Always, follow the best practices in your country, in your state, in your province, in your healthcare institution, to make sure that you are handling this data appropriately and keeping it safe. Thank you again. I hope you have enjoyed this section.