Flowcharting: The Foundation for Making Meaningful Improvements

The flowchart is one of the essential tools in the NIATx model. A flowchart provides visual map of your process—it shows how things get done, step by step. You might be thinking, “Why do we need a flowchart if we already did a walk-through of the process?"

If the process seems straightforward, your team might think that a flowchart is unnecessary. But even simple processes often have hidden inefficiencies that a flowchart can uncover. While some teams may not want to take the time to map out a process, here’s why creating a flowchart is worth the effort:

1. People love visuals. More than half of us are visual learners, so having a picture of the process helps everyone on your team understand and communicate more effectively.
2. Flowcharting builds agreement. Mapping the process forces your team to agree on what the process actually looks like right now. This clarity is key to making meaningful improvements.
3. It sets the stage for analysis. Once your flowchart is complete, your team can easily spot bottlenecks, barriers, and brainstorm ideas for improvement.

The Basics of Flowcharting

To keep things simple, NIATx uses just four basic symbols for flowcharting:

• Oval: Marks the start and end points.
• Square: Represents an action step.
• Diamond: Indicates a decision point (e.g., yes/no questions where the process branches).
• Arrow: Shows the flow and transitions between steps.

How to Build Your Flowchart

Here’s a step-by-step guide to creating your own flowchart:

1. Set up your workspace. While you can draw a flowchart on paper, we suggest Change Leaders use a whiteboard or flip chart, which makes it easier for everyone to participate and see the picture develop. Sticky notes work well for the squares and diamonds because you can move them around easily as you develop your flowchart.
2. Name the process. Write the process name at the top of your board. For example, “Parent and Caregiver Communication Process.”
3. Define the start and end. Place the first and last steps on the board to set your boundaries. For instance, your process might start with scheduling a meeting and end with conducting that meeting.
4. Fill in the steps. Focus on capturing the current process, not your change ideas just yet. Use sticky notes for each step and be ready for some discussion as your team clarifies the process.
5. Include decisions. Add diamonds for any points where the process branches. For example: Did a parent reply to the meeting email? If yes, they get a response. If no, move to the next step.
6. Keep it simple. Don’t bog your chart down with too many details. Highlight the key steps so your team can effectively analyze the process.

A Real-Life Example

Here’s a flowchart for a Parent and Caregiver Communication Process:

• Step 1: Schedule a program meeting.
• Step 2: Send an email notification to parents and caregivers three weeks in advance.
• Step 3: Send a reminder email one week before the meeting.
• Decision Point: Did a parent reply with a question? If yes, send a response. If no, proceed to the meeting.
• Step 4: Conduct the onsite program meeting.

Review and Improve

Once your flowchart reflects the process, it’s time to review. Discuss with your team:

• Are there any bottlenecks or barriers?
• What inefficiencies exist, and how could they be addressed?
• What improvements can you make?

Agree on areas to focus your improvement efforts. Snap a picture of your final flowchart so you can include it in your change project documentation.

Ready to create a flowchart? Download the instructions for the flowchart tool here.

NIATx Change Leader Academy E-Learning Course Flowcharting and other essential NIATx tools will be covered in the new NIATx Change Leader e-learning course, coming to HealtheKnowledge, the ATTC Network’s online learning portal, in 2025! Watch your email for more information.