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  • Shareable Clinical Pathways Tutorial Part 2-Editing Existing Workflows and Additional Lanes

In this post we are building off of our Shareable Clinical Pathways Tutorial Part 1- Basic BPMN Events, Tasks, and Gateways ( post linked here. We will be building off of the workflow that was created in that tutorial so it would be beneficial to review that before reading this post.

In our initial introduction to BPMN and building a simple workflow the ideas of events, tasks and gateways were introduced and a workflow depicting the Radiation Oncologist consult workflow was created. Events, tasks, and gateways are connected together using sequence flows or flows, which consist of a line with an arrow indicating the direction of the sequence. In this post we will build off the Radiation Oncologist Consult Workflow and incorporate additional staff roles with the use of lanes and also covering the editing options that are available.

We will begin with the workflow that we originally created as our starting point. Which is shown below. To create the workflow yourself follow the tutorial using a BPMN modeling tool such as at (create link) If you need help, watch the video beneath where we show the entire model creation.

Step 1: Add additional lanes for nursing and simulation therapists.

Lanes add an additional level of readability and organization to a workflow. You are able to add lanes above, below or divide the current lane into divisions of two or three by selecting the original lane and using the tools to the right of the lane.

Tip: Tools to edit workflows (Add formatting for tips some how?)

Symbols in BPMN are able to be relocated by dragging and dropping in many cases. When tasks are added and removed it can create a disruption in the aesthetic of the workflow. Our modeler within RO Dynamics, as well as other BPMN modelers have a “Create/Remove Space” tool that can be utilized in these cases located in the tool menu on the left.

Tip: To insert between two existing symbols, it is often easiest to delete the sequence flow(s) in between and then branch new symbols off of the previous symbol.

Step 2: Relocate the start event and add a “Pre-Consult” task

Since the first task of the consult workflow will now belong to Nursing, that is why the start event is relocated to the nursing lane along with the additional nursing Pre-Consult with Patient task. The sequence flow now needs to be corrected with a flow going from the Pre-Consult to the Consult with Patient task in the “Radiation Oncologist” lane.

Step 3: Adding a “Schedule Simulation Appointment” task for the simulation therapist

Once the decision for the “Determine if Radiation Therapy Indicated” task is determined as “Yes” then the next symbol is a signal event that will start the radiation course workflow. After this signal event but before the patient consult ends, a “Schedule Simulation Appointment” needs to be added in the simulation therapist lane. Once this is completed, then the Patient Consult workflow is completed and ends with the “Patient Consult Ended” end event.

Now we have worked through how to expand upon an existing workflow. It is evident that the use of BPMN allows you to be flexible as your department needs change over the course of time.

Hannah Shappell

Hannah Shappell is an ARRT certified radiation therapist with years of clinical experience who graduated with a Bachelor of Science in radiation therapy from Texas State University. She now currently resides in beautiful Central Oregon where you will typically find her outside trying to keep up with her two sons, crazy dog, and husband.

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