SIPOC Matrix

Suppliers

Input

Process

Output

Customer

Who do the inputs to the process

come from?

What "thing(s)" go into the

process to generate the output?

Steps or tasks that utilize inputs

and generate output and are of
value to the customer

What does the process

generate?

Proper or personal noun (person,

group, or title)

Noun (a "thing," which includes

information). Should avoid verbs

Should start with a verb

Noun (a "thing," which includes Proper or personal noun (person,

information). Should avoid verbs group, or title)

Patient

~ Vital signs
~ Patient's story
~ Questions about symptoms
~ Possible causation
~ Family history
~ Vitals

Triage patients

~Early assessment
~Vital signs
~ Symptoms
~ Family history
~ Vital signs
~ What events may have triggered issue
according to patient

Patient & Staff

Patient, Insurance

~ Insurance card request

~ Completed and signed admissions
paperwork

Admit patient

~ Coverage for the patient

~ Any signed liability & privacy documents
~ Any other critical information (billing
address, contact information, etc.)

Billing department &

Other staff that needs to communicate
with the patient at a later date

Patient, Previous Nurses

~ Completed/signed admissions paperwork

~ verbal run-down of symptoms & vitals
~ symptoms & other important information
~ Doctor's specific questions and specific
follow-up questions

Assess patient (Doctor)

~ Nurses' detailed issue assessment

~ Patient's detailed issue assessment
~ Doctor opinion
~ Additional paperwork
~ Patient answers to questions
~ Test request/orders & paperwork

Patient & Testing facility

Doctor, Patient

~ Test-request paperwork (fully complete)

~ Test preparation instructions
~ Patient provides samples

Run tests

~ Raw test results

Doctor and patient

Testing Facility
Doctor
Doctor, Patient

Test
Test report
Treatment

Review test report

Treat patient
Discharge patient

~ Diagnosis
~ Wellness for the patient
~ Discharge paperwork (complete with all
information concerning visit and any
followup needed)

Doctor and patient

Doctor and patient
Filing system clerk
Patient

Patient

Assess patient (Nurse)

281790147.xls

Who receives the output of the

process?

Doctor

SIPOC Matrix
Suppliers

Input

Defects

Process

Customer

Noun (a "thing," which includes

information). Should avoid verbs

Patient

~ Vital signs
~ Patient's story

Wrong information

Triage patients

TBD

~Early assessment
~Vital signs

Missing or wrong information; test not ordered that Patient & Staff
could have been ordered early in process to speed
up the process

Assess the problem quickly. Keep in mind the

patient is feeling, " Be nice to me, I'm hurt or
not feeling well."

Patient

~ Questions about symptoms

~ Possible causation
~ Family history
~ Vitals

~ Unnecessary information
~ Missing information
~ Wrong information

Assess patient (Nurse)

Head nurse

~ Symptoms
~ Family history
~ Vital signs
~ What events may have triggered
issue according to patient

~ Patient explains symptoms poorly

Doctor
~ Patient leaving out important information in family
history due to improper questioning techniques
~ Vitals not taken properly
~ Poorly described events leading to
misunderstanding by nurse(s) and/or doctor

~ Providing a proper diagnosis to the issue

~ Limiting the amount of tests needed due to
complete understanding
~ Not missing important tests
~ Avoiding multiple visits or visits to other
offices not needed

Patient, Insurance

~ Insurance card request

~ Patient does not have insurance
Admit patient
~ Completed and signed admissions card or information
paperwork
~ Insurance company is difficult to
work with
~ Patient does not have other critical
information

Admitting supervisor

~ Coverage for the patient

~ Any signed liability & privacy
documents
~ Any other critical information (billing
address, contact information, etc.)

~ It is found that the patient's coverage has lapsed

~ It is found that patient has a large deductable and
must provide payment upfront and patient can't pay
~ Incorrect billing information results in lost bills
~ Admitting cannot contact insurance company to
confirm information

~ The customer is not billed for items that the

insurance company should receive
~ The insurance covers what should be
covered
~ The customer is receives all important
communication in the future.

Patient, Previous Nurses

~ Completed/signed admissions paperwork

~ verbal run-down of symptoms & vitals
~ symptoms & other important information
~ Doctor's specific questions and specific
follow-up questions

~ Nurse passes incorrect information Assess patient (Doctor)

to the doctor
~ Patient provides incorrect
information or leaves out important
information

Doctor in charge of
department

~ Nurses' detailed issue assessment

~ Patient's detailed issue assessment
~ Doctor opinion
~ Additional paperwork
~ Patient answers to questions
~ Test request/orders & paperwork

~ Paperwork filled out inproperly or incompletely

Patient & Testing facility
~ Incorrect assumptions made by previous nurses
~ POV of the patient negatively affects the doctor's
ability to determine the core cause

~ Requested tests are the correct tests that

will determine core cause
~ Avoiding unneeded tests
~ Doctor providing a level of confidence to
the patient that the core cause is
discoverable and treatable

Doctor, Patient

~ Test-request paperwork (fully

complete)
~ Test preparation instructions
~ Patient provides samples

~ Test request is confusing or not

Run tests
specific enough
~ Proper instructions are not given to
the patient for preparation

Floor manager of testing

facility

~ Raw test results

~Wrong data

Doctor and patient

~ The test results are accurate

~ The proper tests were run
~ No tests are missing which would result in a
revisit or further waiting

Testing Facility

Test

~Wrong results
up patient data
~equipment failure

Doctor

~ Diagnosis

~ Misdiagnosis
~Delay diagnosis

Doctor and patient

~Diagnosis are accurate

~Patient symptoms diagnosed properly
~Quickly get the result back to
patient
~The prescription filled out with label

Doctor, Patient

Test report

Treatment

~mixed Review test report

~report sent to another facility

~timeliness deadline not met
~result not ordered

Treat patient

~wrong prescription
~No consultation with Dr

Discharge patient

What can be wrong with the output?

Who receives the output of

the process?

CTQ

Proper or personal noun

(person, group, or title)

Should start with a verb (action

word)

What does the process generate?

Defects

What goes into the process to

generate the output?

Steps or tasks that utilize inputs and generate

output and are of value to the customer

Who is responsible for the

process?

Output

Who do the inputs to the

process come from?

Doctor

What can be wrong with the inputs

going into the process?

Process Owner

Noun (a "thing," which includes

information)

Doctor

~ Wellness for the patient

Admitting supervisor

281790147.xls

What is important about the output to the

customer?

Proper or personal noun

(person, group, or title)

Billing department &

Other staff that needs to
communicate with the
patient at a later date

~Undiagnosis

~Patient not given right treatment

~Patient don't understand how to use treatment to
cure

~ Discharge paperwork (complete with ~No follow up or treatment planning from Dr

all information concerning visit and
~Patient don't understand discharge data
any followup needed)

Doctor and patient

information ~Doctor provide discuss

treatment with patient
Filing system clerk
Patient

~Doctor explained follow up and discharge

instructions
~Thank patient for his/her visits and make
sure they are satisfied