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A Toolkit for Redesign in Health Care: Final Report

Form G. Patient Process Flow Observation Form

Note: Complete each field as necessary based on the experience of the patient.

Observer Name: ___________________________ Department/Area: ___________________________   Page: ___ of ___

Date:  ____/____/____

Patient No.:  (1)  (2) (3)  (4) (5)

Time/Shift: ______________
Activity, Comments Interacted With Time Start Time End Distance Traveled
         
         
         
         
         
         
         
         
         

Page last reviewed August 2016
Page originally created August 2016

Internet Citation: Form G. Patient Process Flow Observation Form. Content last reviewed August 2016. Agency for Healthcare Research and Quality, Rockville, MD.
https://archive.ahrq.gov/patient-safety/resources/resdesign-tool/tkformg.html

 

The information on this page is archived and provided for reference purposes only.

 
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