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[Text on Screen: 
Presents: Process Map Part 4]

[On screen: Process map showing the process from when a patient arrives and checks in to when a patient leaves clinic.]

Narrator: Once your team has created a map of how a process works currently, the next step is imagining how that process could work better.  This is where an ideal state, sometimes also referred to as a future state, process map comes in. Unlike the current state map, which reflects what is, the ideal state map reflects what it could or should be if things were running smoothly, efficiently, and reliably.Ideal process maps can help envision what the process could look like if it worked better for patients, staff, and the system as a whole.

Let's return to our clinic example, where patients reported long appointment times. After reviewing your current state process map, your team decides to design a better version of the workflow. Here's how to begin.

Step 1: Gather input. Start with three key sources. Your current state findings. Where are the gaps, delays, or inconsistencies? Feedback from frontline staff. What do they think could improve the process? Best practices from the literature. What has worked well elsewhere? Together, these inputs give your team a strong foundation for redesign.

Step 2. Sketch the ideal flow. Now, your team reimagines the process using the same standard symbols to design a smoother, more consistent experience. The process starts. The patient receives an automated visit reminder with a pre-visit check-in link. The patient completes the check-in process online before the visit. The care team completes a daily huddle to review the day's schedule and anticipate needs. 

Note that these steps were not on the current state process map. Based on the feedback from frontline staff, current state findings, and best practices from literature, they were added to reflect ideal state of the process.

The patient arrives at the clinic. A designated staff member calls the patient back and records their height and weight.
On the current state, it was noted that a nurse performs this step.
However, after receiving feedback, it was noted that it is not always optimal for this to be in the nurse's workflow, and instead should be a designated staff member such as a medical assistant. The patient is escorted to an exam room. Vital signs are recorded. Medical history and medications are reviewed using a consistent, standardized approach.

The nurse alerts the clinician that the patient is ready using a standardized method, such as EMR plus visual cue. In the current state, your team learned that this step is not always consistent which can lead to the clinician missing the alert. To address this, the ideal state map reflects using a standardized method with better likelihood the clinician will receive the message.

The clinician meets with the patient, addresses concerns, and makes a decision about labs. Are labs needed? If yes, the patient is sent to the lab and labs are completed. A follow-up is scheduled before the patient leaves. The patient leaves the clinic. If no, a follow-up is scheduled before the patient leaves the room. The patient leaves the clinic.

As with the current state, arrows show how each step flows into the next, from rectangle to rectangle or to a decision diamond. You may still use an elongated D to mark expected wait times or a star to flag areas needing further improvement, even in the ideal flow.

Step 3: Validate and balance. Next, review the draft with the people who will carry out the new process. Staff, clinicians, schedulers, or others involved in care delivery. Ask questions like, is this feasible? What trade-offs does this design create? Who benefits and where might friction still exist? An effective ideal state balances priorities. It won't be perfect, but it should be grounded, respectful of real-world constraints, and focused on improving care.

Step 4: Use it to guide action. An ideal state map isn't just a dream. It's a blueprint for testing change. You'll use it to identify where improvement interventions should focus, prioritize what to test, build out action plans with clearer roles and expectations. And just like the system itself, your map is never final. You'll revisit it as you learn what works, adjust to feedback, and adapt to new challenges or opportunities.

To recap, a current state map helps you understand what's happening now. An ideal state map helps your team envision a better way forward. Together, they give you the insight and direction to make meaningful, lasting improvements.

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[Text on screen: Thank you! Scan the QR code for references and resources.]
[QR code links to: https://go.osu.edu/qihub]