Date post: | 29-Oct-2014 |
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Economy & Finance |
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Process and Rules: The Collaboration Effect
Blue Cross Blue Shield of MinnesotaTom Bazzarre, Manager Rules Management Office Sands Mcalees-Callanan, Sr. Process Developer
2
Agenda
> Introductions
> BCBSMN, Process and Rules
> Process & Rule Integrated Model
> Project Outcomes
> Process & Rule Repositories Co-Management
> Customer Reactions
3
Introductions
> Tom Bazzarre, Manager, Rules Management Office and Integration, Business Infrastructure Services
> 15 years experience with Enterprise Operations Support within Financial Industry
> 10 years analyzing, designing, and implementing process improvements
> Accountable for Business Rule Management, Business and System Analysis, Rule Automation and Enterprise Integration support.
4
Introductions
> Sands Mcalees-Callanan, Sr. Process Developer, Business Infrastructure Services
> 12 years experience in the healthcare insurance industry
> Background includes Provider Services, Knowledge and Learning Management and working with the Blue Cross Association Inter-Plan Programs team
> Certified in ITIL Foundations and is a Practitioner in Lean and IT Service Management
> Lead Process Developer in launching the Process and Rules Integrated Model
5
Agenda
> Introductions √
> BCBSMN, Process and Rules
> Process & Rule Integrated Model
> Project Outcomes
> Process & Rule Repositories Co-Management
> Customer Reactions
6
Who is BCBSMN?
BlueCross BlueShield of Minnesota> BlueCross BlueShield of MN is a non-profit health
insurance company providing local and national health coverage for the past 70 years
> Member enrollment is 2.9 million and we process over 39 million health claims per year
> Over 60% of our business is self-funded and we administer benefits for several fortune 500 companies
> Reduction of administrative cost, business differentiation, and agility are critical to remain competitive in this market
7
BCBSMN, Process and Rules
Business Infrastructure Services
> Business Infrastructure Services collaborates with internal partners, by providing business solutions and deployment strategies to manage business rules and process, in order to maximize operational performance
8
BCBSMN, Process and Rules
Business Infrastructure Services
Process Development
Rule Management Office
Integration/Rule Automation
Business DeploymentMe
asu
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C
ha
ng
e
Ma
na
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BCBSMN, Process and Rules
Manager
VP, Business and Technology Infrastructure
Director
Rule Management Office
Intergration/RuleAutomation
Manager
Process Developer
Process DeveloperDeployment Consultant
Process Developer
Process Developer
System Integration Analyst
Rule Management Analyst
System Integration Analyst
Rule Management Analyst
System Integration Analyst
Rules Management Analyst
System Integration Analyst
Rule Project Steward
System Integration Analyst
Rule Project Steward
System Integration Analyst
Rule Project Steward
Rule Project Steward
Process Developer
Process Development
Process and Rules Organization
10
Agenda
> Introductions √
> BCBSMN, Process and Rules √
> Process & Rule Integrated Model
> Project Outcomes
> Process & Rule Repositories Co-Management
> Customer Reactions
11
Process-Rule Integrated ModelBackground> The development of the Process and Rules
Model happened by “chance” with the first project where process and rules staff were both assigned
> Prior to the implementation of this model, requirements were gathered in JAD sessions, where SMEs were expected to supply “everything they know” about a project scope, without any structure around how to organize and communicate their knowledge
12
Process-Rule Integrated ModelBackground
With the Process-Rule model, SMEs are given a structured methodology
The customer decides what process and rule levels they would like to have created and documented
13
Process and Rule relationships- levels 1 through 4 (working document) Process1 Level Description Rules Level
Description
Process and Rules Relationship
When is this level necessary
Level 1 This level shows the basic high level steps of a/the process (approx. 3-7 boxes) to gain a broad understanding of what is done during the process
Level 1 Rules allow for one or more concepts within the high level project scope, to be defined as terms.
Within Level 1 Terms in high level process steps are used consistently and include a clear definition for use throughout the process.
When a general overview of the process is needed and when a project needs to know high level common terminology and how these concepts relate to each other. When a project requires clear understanding of concepts (common terminology) and how these concepts relate to each other at a high level.
Level 2 This level shows which department, role or function, is responsible for specific actions and who is doing what from a task standpoint. Each step of the level 1 would be defined in more task detail with critical decision points.
This level identifies hand-offs and/or interactions by the players in the process.
Level 2 Rules identify the basic terminology, definitions and relationships between terms (aka: Fact Model) and the Governing Rules* within the project scope. *see “When Do You Need This Level” for definition of Governing Rules
Within Level 2 process steps will correlate to Process/Guidance Rules. Decision points will correlate to Decision Rules. Decision points may also be used to establish a classification and hierarchy structure for the rules (aka: Rule Groups).
When processes need to define, with more detail, what is determined in Level 1 but includes critical, high-level decision points and shows hand-offs with responsible parties defined. A level 2 process begins to identify the risks to the process that can be addressed using process improvement. When a project requires only a basic understanding of the Governing Rules related to its scope and the rules will not be implemented as part of the project scope. Examples of Governing Rules are: A legal statement (e.g., law, act, statute, etc.), formal regulation, binding agreement (e.g., contractual obligation), higher-level business policy or directive. Governing rules are often aimed at guiding or constraining the business, regulating its interactions with external parties, and/or limiting its exposure to risks or threats. A Governing Rule is at risk for misinterpretation. Risk is reduced or minimized, by reducing the Governing Rule down to one or more Operating Rules (Level 3) to be applied in an actual business process or system design. Governing Rules are non-automatable.
1 A Process map or flowchart is a method of making a process visible. Note: All process steps should begin with an action verb.
14
Process-Rule Integrated ModelBenefits> The benefits of taking the time to
document the Process and Rules from a business perspective
– Project is clearly defined-”Walk the Wall”
– The captured business knowledge is understood
– Documented Process and Rules are a direct feed to complete Business Requirements
15
Process-Rule Integrated ModelBenefits
– Once all of the process steps, decisions and rules are documented – the analysis of what can be, or even should be automated (agile vs. static), is an easier process for both the business and IT
– Business is provided with a means for effective change management; business artifacts (process, terms, rules) are maintained and available for change impact analysis, external to the applications
16
Process-Rule Integrated ModelRoles and Responsibilities
Business SMEs andStakeholders
Rules Steward
Process Developer
Process FacilitatorBusiness Owner
IT Business Analyst
IT Project Manager
17
Process-Rule Integrated Model
Project Assignment
DevelopCharter and Work Plan
Kickoff Conduct Meeting(s) Transition
Capture A
s Is
Terms and R
ules
Facilitate As Is Process
Docum
ent
As Is P
roce
ss
Capture To B
e
Terms and R
ules
Facilitate To Be Process
Document
To Be P
roce
ss
18
Process-Rule Integrated Model
Project Assignment
Develop Charter and Work Plan
Kickoff Conduct Meeting(s)
Process Facilitated (As Is) Process Documented
Process Developers guide the SMEs in gathering and documenting the process· 3 + hour
meetings on consecutive days if possible
· Agenda· Use post it
notes and wall posters
· Use probing questions
· Create a collaborative, fun atmosphere
The processes documented according to the Business Process Map Formatting Guidelines unless otherwise requested
· The group uses the wall process and is not interrupted by formatting, spelling etc. allowing for timing and synergy
· Using a lap top, the rough draft process is captured on line during facilitation
· Process Documenter and Process Facilitator meet after the meeting to ‘polish’ the documented processes
· Processes are ready to be validated at the very next meeting· The group sees immediate results of their time and effort· The processes are still fresh in their minds and detracts from
having to back track to re-fresh memories
Review and Gain Business Champion/ Owner(s) approval (sign off) for:· Business
Problem Statement
· Business Owner and Stakeholders Established
· Project Objective
· Process and Rules Deliverables
· Project Team· Process and
Business Scope
· Timelines and Milestones
· Business Engagement Assessment
· Process Detail Level
Establish Project Team’s understanding of:· Charter
Content· Each
person’s role/ responsibility
· Meeting schedule and/or participant availability
· Project approach
Resource and Project Planning Meeting· Process
Facilitator· Process
Documenter· Business
Rule Steward· Business
Rule Analyst· Business
Owner(s) and or Sponsor(s)
· Enterprise Project Management Office, when applicable
· Product Development, when applicable
· Virtual Design, when applicable
Expanded intake form is completed
19
Process-Rule Integrated Model
Project Assignment
Develop Charter and Work Plan
Kickoff
Review and Gain Business Champion/ Owner(s) approval (sign off) for:· Business
Problem Statement
· Business Owner and Stakeholders Established
· Project Objective
· Process and Rules Deliverables
· Project Team· Process and
Business Scope
· Timelines and Milestones
· Business Engagement Assessment
· Process Detail Level
Establish Project Team’s understanding of:· Charter
Content· Each
person’s role/ responsibility
· Meeting schedule and/or participant availability
· Project approach
Conduct Meeting(s)
Process Facilitated (As Is)Based on the process map level (1, 2, 3, 4) determined in the Planning meeting, Process Developers guide the SMEs in gathering and documenting the process· 3 + hour meetings on consecutive days, if possible· Use post it notes and wall posters
Process Map (blank and/or work in process) Parking Lot Issues Opportunities Roadblocks
· Use probing questions to pull out the processHow, what, when, where, which, why, who
· Create a collaborative, fun atmosphere
Resource and Project Planning Meeting· Process
Facilitator· Process
Documenter· Business
Rule Steward· Business
Rule Analyst· Business
Owner(s) and or Sponsor(s)
· Enterprise Project Management Office, when applicable
· Product Development, when applicable
· Virtual Design, when applicable
Expanded intake form is completed
20
Process-Rule Integrated Model
Project Assignment
Develop Charter and Work Plan
Kickoff Conduct Meeting(s)Process
Facilitated (As Is)Process
Documented
· Documented according to the Business Process Map Formatting Guidelines
· Use the wall process
· Using a lap top, the rough draft captured during facilitation
· Processes are ready to be validated at the very next meeting
· The group sees immediate results
· Processes stay fresh
Business Terms and Rules Captured
· Participate in meetings; learn the "language of the project"· Ask clarifying questions to capture details for terms,
definitions, fact model and rules· Identify synonyms · Promote the reuse of terminology and rules · Document and validate terms, definitions, fact model and
rules · Continually educate on the differences between business
rules and system rules· Develop rules based on business knowledge, not based on
system limitations, requirements, or expectations
Process Developers guide the SMEs in gathering and documenting the process· 3 + hour
meetings on consecutive days if possible
· Agenda· Use post it
notes and wall posters
· Use probing questions
· Create a collaborative, fun atmosphere
Review and Gain Business Champion/ Owner(s) approval (sign off) for:· Business
Problem Statement
· Business Owner and Stakeholders Established
· Project Objective
· Process and Rules Deliverables
· Project Team· Process and
Business Scope
· Timelines and Milestones
· Business Engagement Assessment
· Process Detail Level
Establish Project Team’s understanding of:· Charter
Content· Each
person’s role/ responsibility
· Meeting schedule and/or participant availability
· Project approach
Resource and Project Planning Meeting· Process
Facilitator· Process
Documenter· Business
Rule Steward· Business
Rule Analyst· Business
Owner(s) and or Sponsor(s)
· Enterprise Project Management Office, when applicable
· Product Development, when applicable
· Virtual Design, when applicable
Expanded intake form is completed
21
Process-Rule Integrated Model
Project Assignment
Develop Charter and Work Plan
Kickoff Conduct Meeting(s)
New Design Facilitated (To Be)
Based on the opportunities and steps gathered during the high level as is process, the process facilitator will· Gather utopia from the SME’s for the new
process· Using the project objectives, take utopia and
build the realistic to be process· Draw out enhancements and process
improvements for the new process· Incorporate rules supporting the new process· Identify automation opportunities in the to be
process
Business Terms and Rules Captured
· Learn "language of the project"
· Identify synonyms
· Promote the reuse of terminology and rules
· Document and validate terms, definitions, fact model and rules
· Continually educate on the differences between business rules and system rules
· Develop rules based on business knowledge
Process Facilitated (As Is)
Process Documented
· Documented according to the Business Process Map Formatting Guidelines
· Use the wall process
· Using a lap top, the rough draft captured during facilitation
· Processes are ready to be validated at the very next meeting
· The group sees immediate results
· Processes stay fresh
Process Developers guide the SMEs in gathering and documenting the process· 3 + hour
meetings on consecutive days if possible
· Agenda· Use post it
notes and wall posters
· Use probing questions
· Create a collaborative, fun atmosphere
Review and Gain Business Champion/ Owner(s) approval (sign off) for:· Business
Problem Statement
· Business Owner and Stakeholders Established
· Project Objective
· Process and Rules Deliverables
· Project Team· Process and
Business Scope
· Timelines and Milestones
· Business Engagement Assessment
· Process Detail Level
Establish Project Team’s understanding of:· Charter
Content· Each
person’s role/ responsibility
· Meeting schedule and/or participant availability
· Project approach
Resource and Project Planning Meeting· Process
Facilitator· Process
Documenter· Business
Rule Steward· Business
Rule Analyst· Business
Owner(s) and or Sponsor(s)
· Enterprise Project Management Office, when applicable
· Product Development, when applicable
· Virtual Design, when applicable
Expanded intake form is completed
22
Process-Rule Integrated Model
Project Assignment
Develop Charter and Work Plan
Kickoff Conduct Meeting(s)
Process Facilitated (As Is)
New Design Facilitated (To Be)
Process Documented
Based on opportunities and steps gathered, the process facilitator will· Gather utopia
from the SME’s for the new process
· Using the project objectives, take utopia and build the realistic to be process
· Incorporate rules supporting the new process
· Identify automation opportunities
Business Terms and Rules Captured Validation
Begin the workgroup by validating processes created at last meeting· Ensures accuracy and includes any
changes missed · All necessary updates will be
documented and if needed another meeting will be set up
· Once the validation phases are complete, appropriate documentation will be moved out of ‘draft’ status and placed in ‘final’ status
· Updates are also provided on the assigned Parking Lot issues and opportunities
· Learn "language of the project"
· Identify synonyms
· Promote the reuse of terminology and rules
· Document and validate terms, definitions, fact model and rules
· Continually educate on the differences between business rules and system rules
· Develop rules based on business knowledge
· Documented according to the Business Process Map Formatting Guidelines
· Use the wall process
· Using a lap top, the rough draft captured during facilitation
· Processes are ready to be validated at the very next meeting
· The group sees immediate results
· Processes stay fresh
Process Developers guide the SMEs in gathering and documenting the process· 3 + hour
meetings on consecutive days if possible
· Agenda· Use post it
notes and wall posters
· Use probing questions
· Create a collaborative, fun atmosphere
Review and Gain Business Champion/ Owner(s) approval (sign off) for:· Business
Problem Statement
· Business Owner and Stakeholders Established
· Project Objective
· Process and Rules Deliverables
· Project Team· Process and
Business Scope
· Timelines and Milestones
· Business Engagement Assessment
· Process Detail Level
Establish Project Team’s understanding of:· Charter
Content· Each
person’s role/ responsibility
· Meeting schedule and/or participant availability
· Project approach
Resource and Project Planning Meeting· Process
Facilitator· Process
Documenter· Business
Rule Steward· Business
Rule Analyst· Business
Owner(s) and or Sponsor(s)
· Enterprise Project Management Office, when applicable
· Product Development, when applicable
· Virtual Design, when applicable
Expanded intake form is completed
23
Process-Rule Integrated Model
Project Assignment
Develop Charter and Work Plan
Kickoff Conduct Meeting(s)
Process Facilitated (As Is)
New Design Facilitated (To Be)
Process Documented
Business Terms and Rules Captured
Validation
· Ensures accuracy
· Necessary updates documented
· Once the validation phase is complete, appropriate documentation is moved out of ‘draft’ status and placed in ‘final’ status
· Updates are also provided on the assigned Parking Lot issues and opportunities
TransitionProcess and Rule Developers meet with Sponsors, identified Business, Process and Map Owners to provide a final summary · Training for Business to
maintain processes and rules in the repositories
· Documentation and maintenance are the responsibility of the Process and Rule Owners
· Survey is sent out to determine lessons learned from the project
Based on opportunities and steps gathered, the process facilitator will· Gather utopia
from the SME’s for the new process
· Using the project objectives, take utopia and build the realistic to be process
· Incorporate rules supporting the new process
· Identify automation opportunities
· Learn "language of the project"
· Identify synonyms
· Promote the reuse of terminology and rules
· Document and validate terms, definitions, fact model and rules
· Continually educate on the differences between business rules and system rules
· Develop rules based on business knowledge
· Documented according to the Business Process Map Formatting Guidelines
· Use the wall process
· Using a lap top, the rough draft captured during facilitation
· Processes are ready to be validated at the very next meeting
· The group sees immediate results
· Processes stay fresh
Process Developers guide the SMEs in gathering and documenting the process· 3 + hour
meetings on consecutive days if possible
· Agenda· Use post it
notes and wall posters
· Use probing questions
· Create a collaborative, fun atmosphere
Review and Gain Business Champion/ Owner(s) approval (sign off) for:· Business
Problem Statement
· Business Owner and Stakeholders Established
· Project Objective
· Process and Rules Deliverables
· Project Team· Process and
Business Scope
· Timelines and Milestones
· Business Engagement Assessment
· Process Detail Level
Establish Project Team’s understanding of:· Charter
Content· Each
person’s role/ responsibility
· Meeting schedule and/or participant availability
· Project approach
Resource and Project Planning Meeting· Process
Facilitator· Process
Documenter· Business
Rule Steward· Business
Rule Analyst· Business
Owner(s) and or Sponsor(s)
· Enterprise Project Management Office, when applicable
· Product Development, when applicable
· Virtual Design, when applicable
Expanded intake form is completed
24
Agenda
> Introductions √
> BCBSMN, Process and Rules √
> Process & Rule Integrated Model √
> Project Outcomes
> Process & Rule Repositories Co-Management
> Customer Reactions
25
Project Results: Collaboration Effect> We have 5 on-going projects using the
Process/Rules Integration model:– IT Engineering– Incentive Based Benefits– Business Incident and Request Management– Administrative Simplification– Integrated Health Management
> The one that started it all: – Corporate Security Event Documentation and
Investigation Management
26
Project Results: Corporate Security Event Documentation and Investigation Management
•Project Objective: Purchase a Workflow/Rule Automation tool to facilitate Event Management tasks and cross-departmental handoffs and ensure accurate reporting
• All processes and rules “known” by two departmental employees; not documented
• Project Manager recognized need for process and rule documentation when trying to develop requirements for RFI/RFP processes
27
Project Results: Corporate Security Event Documentation and Investigation Management
Process Development
Rules Management
Corporate Security
Information SecurityHuman Resources
Compliance
IT Project Manager
Project Participants
•Project Manager
•4 Business Departments/ 10 SMEs
•Process Facilitator
•Process Developer
•Rule Steward
28
Project Results:More deliverables than meetings!
• 25 drilled down (level 4) processes documented and validated
• 22 detailed processes (level 2 & 3) captured and approved
• 178 terms defined and validated • Fact model developed and validated • 337 business rules captured and validated• Road blocks mitigated and parking lot items
documented• Process improvement and automation opportunities
identified and assigned• 44 Meetings over a 4 month time frame
29
Where We Started
30
> Insert picture of process documented with few stickies
Validate the Process
31
Final process with business rules
Eagan Campus
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Receive notification of an
event type- medical
emergency
Notification may be received via:· Phone call to
security officer in SCC at X21212 (SCC is available 24 hrs)
· In person via lobby or communication center
· Direct observation by Corporate Security Staff
Begin to fill out the Medical Injury Report form with the reporting party on-line.
Is the location District
Office, Eagan Campus, or Northern Campus?
District Office
Go to 01.03.1.1
ME DistrictOffice
Wait for resolution. Complete gathering information from the
reporting party, contract security and medical team
and document in the Medical Injury Report form
indicating if person was transported
Dispatch Medical Team via AlertFind
indicating if 911 has been called
Does impacted
party exhibit any of the symptoms/injuries on the list that
may require 911/CER? e.g.· Severe breathing· Shortness of breath· Chest pain· Signs of stroke
Does 911/CER need to be
called if hasn’t?
NoDirect Security Communication Center that 911/CER should be
called
Instruct reporting party help is on the way-· Request not to move the impacted
person· If CERS were called request if someone
is available to meet them at door when they arrive.
Yes
Is 911/CER needed?
Call taxi and
give out voucher
Does impacted person require
nonambulance transportation for further medical
attention?
Go to 01.03.1.3
ME Northern Campus
Northern Campus
Is this Medical
Emergency occurring during BCBSMN business hours?
No
Call 911/CER
Yes
Dispatch contract Security
· Arrive at scene· Direct CER if called to the
site, and stay until they leave· Assist medical team if
present· Perform crowd control if
necessary· Gather data for the event and
report back to SCC
Instruct reporting party help is on the way-· Medical team has been called· Request not to move the
impacted person· Request someone to stand in
aisle to direct medical team when they arrive
· If CER was called instruct someone to meet them at door
Yes
call 911/CER
No
Is this Med
Emerg occur-ing during business hours?
No
Call 911/CER
Me
dic
al
Te
am
Was 911/CER called?
No
Yes
EndYes
Call taxi and give out
voucher and notify Security
Communication
Go to Impact Business on
01.03.1.1
Where is the list? Needs to be formalized
Arrive at scene and assess condition of
impacted person and treat
Does impacted person have
someone who is a nonblue cross employee who could come pick
them up?
No
EndNo Yes
Obtain:· Name of impacted person if
available · Name of reporting party · Call back # and office # of the
reporting party Description of the event from the
reporting party
*CER=Community Emergency Responder
Remain on scene till
ride arrives
Complete Emergency Medical Report and route to Corp Safety Coord.
Receive Emergency Medical Team Report several days after the
event.
End
Review report along with AlertFind and Incident report if
requested
Does medical team
need to be consulted?
Consult filth
Medical Team
Yes
No
Go to A
A
Contract-First responders are
CPR and first-aid trained
Go to B
B
Does impacted person
require nonambulance transportation
for further medical attention?
Does impacted person
have someone who is a nonblue cross employee
who could come pick them up?
No Yes
Yes
No
Yes
Go to C
C
Yes
No
Receives AlertFind and calls into SCC to indicate if
available. If available to respond, obtain details of
event such as location, etc
Receive report from AlertFind after
notifying Medical team indicating which team members responded
to the emergency.
Was notification received
of first report of injury?
No
Go to 01.03.1.1
First report of injury
Yes
01.03.1.2 Med Emerg
Eagan
Notify Security Communication
Does investigation
need to occur?
NoGo to investigate Yes
32
Fact Model Delivered!
Case
Case numberCase statusCase status dateCase status typeCase status type dateCase ownerCase originatorCase origination dateCase origination timeCase notesRestricted access Case assignmentCase assignment dateCompliance Hotline response
Investigation
Event
Event-related Party
Event Notification
Review
Referral
Case review dateCase review update
Investigation findingsInvestigation completion date
Referral dateReferral descriptionReferral responseReferral response dateReferred to partyExpected referral response dateReferral time
Event time Event date Event description Event categoryEvent subcategoryEvent typeEvent buildingEvent building floorEvent locationEvent resolutionNature of event Event itemEvent item typeRoot cause / motive (has employee factors and workplace factors)
Event notification timeEvent notification dateEvent notification method
Project Fact Model: Corporate Safety and Security Event Management and Documentation
includes
includes
includes
includes
includes
requires[Case Review]
assigned to
includes
Event roleEvent role typeEvent role subtype
ConsultationConsultation dateConsulted party
includes
Case review requirement
Case review requirement date
includes
is highly confidential?is Compliance Hotline referral?
Response
receives Referral response dateExpected referral response date
[Referral Response]
includes
33
> Rule 100212 StatementA case assigned to a Corporate Security event must include all of the following:- Case number - Valid case owner - Valid case status - Valid case status type - Case originator - Case status date - Case review indicator - Case review date (s), if case review is indicated- Case review update , if case review is indicated - Valid initial event category - Valid initial event subcategory , if applicable- Valid initial event type , if applicable - Valid event building - Event building floor - Event location - - Event notification time - Valid event notification method - Investigation findings , if investigation was warranted
What Rules Look Like
34
Process with Rule References
Eagan Campus
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Receive notification of an event
type- medical
emergency
Fill out the Medical Injury Report form with the reporting party on-line.
Is the location District
Office, Eagan Campus, or Northern Campus?
District Office
Go to 01.03.1ME District
Office
Wait for resolution. Complete gathering information from the
reporting party, contract security and medical team
and document in the Medical Injury Report form
indicating if person was transported
Dispatch Medical Team via AlertFind
indicating if 911 has been called
Does impacted
party exhibit any of the symptoms/injuries on the list that
may require 911/CER? e.g.· Severe breathing· Shortness of breath· Chest pain· Signs of stroke
Does 911/CER need to be
called if hasn’t?
NoDirect Security Communication Center that 911/CER should be
called
Instruct reporting party help is on the way-· Request not to move the impacted
person· If CERS were called request if someone
is available to meet them at door when they arrive.
Yes
Is 911/CER needed?
Call taxi and
give out voucher
Does impacted person require
nonambulance transportation for further medical
attention?
Go to 01.03.3 ME Northern
Campus
Northern Campus
Is this Medical
Emergency occurring during BCBSMN business hours?
No
Call 911/CER
Yes
Dispatch contract Security
· Arrive at scene· Direct CER if called to the
site, and stay until they leave· Assist medical team if
present· Perform crowd control if
necessary· Gather data for the event and
report back to SCC
Instruct reporting party help is on the way-· Medical team has been called· Request not to move the
impacted person· Request someone to stand in
aisle to direct medical team when they arrive
· If CER was called instruct someone to meet them at door
Yes
call 911/CER
No
Is this Med
Emerg occur-ing during business hours?
No
Call 911/CER
Me
dic
al
Te
am
Was 911/CER called?
No
Yes
EndYes
Call taxi and give out
voucher and notify Security
Communication
Go to Impact Business on
01.03.1Where is the list? Needs to be formalized
Arrive at scene and assess condition of
impacted person and treat
Does impacted person have
someone who is a nonblue cross employee who could come pick
them up?
No
EndNo Yes
*CER=Community Emergency Responder
Remain on scene till
ride arrives
Complete Emergency Medical Report and route to Corp Safety Coord.
Receive Emergency
Medical Team Report several days
after the event.
End
Review report along
with AlertFind
and Incident report if
requested
Does medical team
need to be consulted?
Consult filth
Medical Team
Yes
No
Go to A
A
B
Does impacted person
require nonambulance transportation
for further medical attention?
Does impacted person
have someone who is a nonblue cross
employee who could come pick them up?
No Yes
Yes
No
Yes
Go to C
C
Yes
No
Receives AlertFind and calls into SCC to indicate if
available. If available to respond, obtain details of
event such as location, etc
Receive report from AlertFind after
notifying Medical team indicating which team members responded
to the emergency.
An hour later
Was notification received
of first report of injury?
No
Go to 01.03.1
First report of injury
Yes
01.03.2 Med Emerg
Eagan
Notify Security Communication
Does investigation
need to occur?
Go to investigate
Rule 100256Rules100267100274100275
Rules:Case Fields1002121002511002130100213510021161002951002611002114100293
Rule 100272
Rule 1002177
Rules1002177100298
Rule 100296
Rule 100299
Rule 1002105
Rule 100296Rule
1002102
Rule 1002102
Rule 1002113
I don’t see much that is rule material through this
section, until investigate
Rule 100279Verified with Steve and Jenn that over 80% of the time, taxi vouchers will be handled by the
Medical Team
Rule100295
1002108
Rule 1002108 Rule 1002108
Rule 1002108
Rule 1002108 Rule 1002109Rule 1002108
Rule 1002106
This is about making sure anything you specified be captured in your case information be completed. It’s not a separate rule, in my opinion.
35
Process documentation benefits for our customers• Clear point of reference
• Training
• Continuity
• Adaptability
• Accountability
• Efficiency
• Opportunities Identified
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Opportunities Captured
Mtg Date Issue Assigned to: Do-ability Outcome StatusKeep two invoicing processes alike - Need to make them consistent and streamlines as today they are varied and different.- most manually done-
accurate number of non-benefit information for billing requirements – need billing info automation of rates - would save re-work of reentering the info Don’t always match – increased error – not enough time and staff to catch.
Order form in Lotus database – just send auto notification – saves space and it is there in one accessible placeOne copy if there is a revision current on Lotus – reduces errors if declined - removed – documented
Invoicing - Opportunities
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Benefits of Terms and Rules Captured • Consistent, defined language
• Natural language rule statements
• Granular level rules - can't be misinterpreted
• Traceability
• Motivation
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Wins from the first project:
> It is more efficient for the customer to combine rules and process – although the focus of Rules and Process are different
> Rules Steward gains a deeper understanding of the process and does not have to spend as much time on the back end reviewing
> Rules Steward gains trust of the customer from the beginning – doesn’t have to build the relationship
> Customers gain a better understanding of what the rules are and how they work because they are discussed during the process
> Rules are written for the business, by the business – our business customers are happy to speak their own language and have someone else wonder who will make the system stuff happen!
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Lessons Learned from our first project:> Need strong communication between Rules and
Process team to know when review of Rules needs to be done
> If terminology is introduced by the Rules Team the Process team will re-use it
> Facilitation skills are critical along with human relation skills – for both process design and rules capture
> Need to obtain commitment up front by having sponsor/governing body sign off
> Charter needs to declare the processes and rules levels to be designed and their priority
40
Agenda
> Introductions √
> BCBSMN, Process and Rules √
> Process & Rule Integrated Model √
> Roles & Responsibilities √
> Project Outcomes √
> Process & Rule Repositories Co-Management
> Customer Reactions
41
Process/ Rule Repositories Co-Management
42
Process/ Rule Repositories Co-Management
43
Process/ Rule Repositories Co-Management
44
Agenda
> Introductions √
> BCBSMN, Process and Rules √
> Process & Rule Integrated Model √
> Roles & Responsibilities √
> Project Outcomes √
> Process & Rule Repositories Co-Management √
> Customer Perspectives
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Customer Perspectives
IT Project Manager
> Thank you for your help and involvement with this effort. My main observation is that the involvement of your team really helped to clarify and articulate business requirements relating to potential technical work. It is always a challenge to bridge the 'business/IT gap'. I think your work really helped to close the gap, and enable the BA to complete his work with less effort on his part.
Lead IT Business Analyst
> Your team successfully brought together the Product Management Department in a consistent and reliable manner and produced good deliverables that I could use to further refine and define business requirement documentation.
> You established a good rapport with the subject matter experts and were able to gather a significant amount of detail for some complicated processes.
46
More from our Customers
Project Subject Matter Expert
> The success that I saw was your team’s ability to gain commitment from the IT department to attend the beginning part of the meetings. You assisted in the detailed documentation of the process. These meetings were between 2-3 hours and you made them enjoyable and yet productive. You and the team’s ability to drill down to the details, capture parking lot issues/concerns and document opportunities was extremely helpful to the Product Management team.
Project Manager
> One big success is simply the fact that your team took the time to move this project forward. We needed someone with the experience of your team to lead the effort of getting things documented thoroughly and accurately, and keeping things organized & tracked. Members of the project team haven't had time to do this on our own due to the workload (which is why we are doing this work!) so we truly appreciate your efforts!
> Another success is that these efforts are reusable for future projects
47
Thoughts? Comments? Questions?
48
Contact Information
> Tom Bazzarre, 651-662-4749– [email protected]
> Sands McAlees-Callanan 651-662-8545– [email protected]