A BPMN Based Notation for the Representation of Workflows in Hospital Protocols

J Med Syst. 2018 Aug 29;42(10):181. doi: 10.1007/s10916-018-1034-2.

Abstract

Flowcharts used for hospital protocols have a series of ambiguities and limitations in order to express some types of information. In this article, a notation proposal for flowcharts that partially avoids these problems is presented. This new notation is an adaptation of BPMNE2, an extension of the Business Process Model and Notation (BPMN), which allows direct modelling of procedures that follow the Hazard Analysis and Critical Control Points (HACCP) model. The new notation has been validated in the hospital context, specifically in the field of hazardous drugs (HDs). To measure usability from the perspective of the health staff and auditors, the System Usability Scale (SUS) was used. A total of 47 experts took part in the assessment, resulting in a SUS score of 71, that corresponds to an acceptable level of usability. The feedback provided by these participants allows us to discover benefits and drawbacks of the proposal. Also, it is noteworthy that 76.6% of professionals prefer to migrate to the new notation from the ISO 5807:1985 notation, the most commonly used model. In addition to the direct benefits of this notation from the human point of view, its machine-understandable nature provides the required support for its integration into software tools for intelligent monitoring and auditing.

Keywords: BPMN; Flowcharts; HACCP; Hazardous drugs; Hospital protocols; System usability scale.

MeSH terms

  • Clinical Protocols*
  • Hospitals
  • Humans
  • Software*
  • Workflow*