1. Imagine you are the supervisor of the health information management (HIM) department in a large outpatient clinic. This department manages patient records. Complaints about your department are becoming more frequent and intense than in the past. Some clinic employees have complained that the HIM department takes too long to retrieve patient records. Others have expressed dismay over the rudeness of HIM staff. You decide to talk about these problems with employees throughout the clinic. The clinic's receptionists respond to you defensively. They tell you that the HIM staff won't answer the phone and that they want some backup when they are busy with patients. You talk to the HIM staff and find their stories are just as negative. They say they are being charged with more responsibilities but have no additional help. They also complain that the receptionists transfer calls that they should be handling. The clinic's nurses are also upset with the HIM staff; they claim the department does not help them locate patient charts, causing long wait times for patients. The clinic's physicians say they cannot assume additional tasks to alleviate the situation because their days are already chaotic.

a. What improvement tool would you use to identify possible reasons for the increase in complaints about the HIM department? Provide at least two improvement tools and explain why you think that those are the appropriate tools for this purpose.

b. What improvement tool would you use to define the current process for retrieving patient records?

2. PDSA is the most widely recognized improvement process today. Summarize the main steps of each PDSA phase.