Process mapping: a tool to foster intra- and inter-organizational coordination in primary care

Background
Methods and tools to support the analysis, discussion and improvement of intra- and inter-organizational processes in primary care settings are in urgent need.

Objectives
Our goal is to show how using Petri nets to map processes in health centers may improve intra- and inter-organizational coordination of care.

Material and methods
We carried out a case study on a health center located in the Centro Region of Portugal. Information was collected through direct observation, documental analysis and semi-structured interviews to relevant collaborators. Petri nets were used as a modeling tool.

Results
Generally, health center collaborators do not have a global vision of the processes in which they are involved. Process mapping has allowed one to identify the specificities of each process, sub-processes and tasks and related documentation and actors; to identify transitions of care, to define and to represent the actions, waiting times and decisions in a visual way and to promote the enlarged discussion of processes, tacit knowledge and working practice. A number of opportunities for process improvement have been identified, namely in care transitions where patient management and safety are critical.

Conclusions
Process modelling techniques are an effective tool to support better process design and implementation and more effective coordination of care intra- and inter-organizations. They may be used at several levels, to allow depicting and visualizing more or less detail in a particular process, depending on the objective of the exercise and the actors involved.