| Course | NR 543 Information Workflow in Healthcare |
|---|---|
| Week | 3 |
| Paper type | Current state map |
| Length | About 1,030 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nursing Informatics |
| Updated | September 2026 |
Free sample paper for NR 543 Week 3
Current State Map: The Inpatient MRI Process on a Stroke Unit Drawn From Two Weeks of 38 Requests Rather Than From Memory, Eight Steps, Three Queues and Two Loops That Send Work Backward
Student Name
College of Nursing, Chamberlain University
NR 543: Information Workflow in Healthcare
Instructor Name
Month Day, Year
Current State Map: The Inpatient MRI Process on a Stroke Unit Drawn From Two Weeks of 38 Requests Rather Than From Memory, Eight Steps, Three Queues and Two Loops That Send Work Backward
Why Draw It Again
When I asked staff on our stroke and neuroscience unit to sketch how an inpatient MRI happens, every sketch was a straight line: order, protocol, screening, schedule, transport, scan. Draw a process from memory and it comes out as a line. Sit with it for a morning and it comes out as a loop with three places to sit down. This current state map is the second drawing. It is built from a day of direct observation of three requests and from system timestamps for all 38 inpatient brain MRI requests from the unit over two consecutive weeks, drawn from order audit trails, the MRI scheduling log and transport records.
The Map in Steps
The process has eight steps. Each is described with its median work time and the median wait before it begins, across the 38 requests. Step 1, order entry by a provider: work about 3 minutes; no wait. Step 2, protocol assignment by a neuroradiologist: work about 2 minutes; median wait 2 hours 5 minutes, longest for orders placed between 7 and 10 a.m. Step 3, MRI safety screening by the patient's nurse: work about 10 minutes; median wait 1 hour 40 minutes, but the range runs from 10 minutes to more than 20 hours. Step 4, screening review by the MRI technologist: work about 3 minutes; median wait 35 minutes. Step 5, slot assignment by the scheduler: work about 2 minutes; median wait 1 hour 10 minutes before assignment, then a median of 4 hours 20 minutes until the assigned slot. Step 6, transport request and pickup: work about 8 minutes; median wait 32 minutes. Step 7, scan: about 25 minutes. Step 8, report by the radiologist: median 1 hour 50 minutes after the scan.
The median elapsed time from order to report was 17 hours 45 minutes. The median time anyone spent working on a request was 53 minutes.
The Three Queues
Three places in the map are queues, points where requests from many patients wait for one resource. The protocol queue waits for a neuroradiologist, who reads urgent studies first; inpatient MRI protocols wait until emergency work is cleared. The slot queue waits for one of six inpatient MRI slots a day on a single scanner shared with outpatients and the emergency department. The report queue waits for a radiologist after the scan. Each queue belongs to radiology, and each is visible to radiology as a worklist.
The Two Loops
Two loops send work backward, and neither appears on anyone's sketch.
The screening loop. In 11 of 38 requests, the technologist's review at step 4 found the screening form incomplete or uncertain, usually about implants, and returned it to the nurse. The request then waited at step 3 again. The most common cause was a patient who could not answer, with no family present and no implant record in the chart. In three requests, the loop repeated twice. Professional guidance on MR safety requires that implants and devices be identified before a patient enters the scanner area (Kanal et al., 2013), so the technologist's return is correct; the loop exists because the information is hard to obtain, not because anyone is careless.
The lost-slot loop. In 6 of 38 requests, the patient was not ready when the slot arrived, most often because transport was late or the screening loop was still open, and the slot was given to another patient. The request returned to step 5 and waited for a new slot, a median of 5 hours.
Where the Places to Sit Down Are
Measured by total waiting across all 38 requests, the largest share of waiting occurred before the assigned slot, at step 5, followed by the screening step, including its loop, and then the morning protocol queue. But the median hides an important difference. For patients who could answer screening questions, the screening step was short and the slot wait dominated. For the 14 patients who could not answer, because of aphasia, confusion or sedation, the screening step and its loop were the largest wait, often more than all the others combined.
What the Map Shows That Memory Did Not
The remembered process treated screening as a quick nursing task. The data show it as the most variable step and the start of a loop that sends a third of requests backward. The remembered process treated the slot as a scheduling detail. The data show that slots are few, fixed and lost when anything upstream runs late. Lean approaches to health care improvement start from the current state as it is, not as it is described, precisely because the difference is where improvement lies (Mazzocato et al., 2010).
The map also shows who owns each wait. Radiology owns the three queues and can see them. The screening wait and its loop belong to no one in particular: they sit between the unit, the patient's family and the technologist. That ownership gap is the reason the screening loop had not been noticed.
Limits of the Map
The map is built from two weeks and 38 requests on one unit. Timestamps record when people entered actions in the system, not when they did them, and a study of time and motion methods notes that such data can misrepresent task timing (Zheng et al., 2011). The observation day helped check timestamps, and most differences were a few minutes. The map also does not include requests from other units, which compete for the same slots. The next steps, a handoff analysis and a workaround write-up, will examine the screening loop more closely, since it is the part of the map least understood by the people inside it.
References
Kanal, E., Barkovich, A. J., Bell, C., Borgstede, J. P., Bradley, W. G., Froelich, J. W., Gimbel, J. R., Gosbee, J. W., Kuhni-Kaminski, E., Larson, P. A., Lester, J. W., Nyenhuis, J., Schaefer, D. J., Sebek, E. A., Weinreb, J., Wilkoff, B. L., Woods, T. O., Lucey, L., & Hernandez, D. (2013). ACR guidance document on MR safe practices: 2013. Journal of Magnetic Resonance Imaging, 37(3), 501-530. https://doi.org/10.1002/jmri.24011
Mazzocato, P., Savage, C., Brommels, M., Aronsson, H., & Thor, J. (2010). Lean thinking in healthcare: A realist review of the literature. Quality and Safety in Health Care, 19(5), 376-382. https://doi.org/10.1136/qshc.2009.037986
Zheng, K., Guo, M. H., & Hanauer, D. A. (2011). Using the time and motion method to study clinical work processes and workflow: Methodological inconsistencies and a call for standardized research. Journal of the American Medical Informatics Association, 18(5), 704-710. https://doi.org/10.1136/amiajnl-2011-000083
Reading the NR 543 Week 3 instructions
Mapping the current process is the core of the third week. Expect the instructions to request a visual or step-by-step map, the data behind it, identification of delays, queues and rework, and a discussion of what the map reveals. Build the map from records and observation, not from a meeting where people describe how things should work. List each step with its owner and typical duration. Mark every place where work waits and give the median wait. Show loops, where work goes backward, because staff often forget them. Report the overall elapsed time and the total work time. Compare the map with how staff first described the process. Admit the limits of your data. Support the approach with a source on lean or process mapping, cited in APA 7.
How this NR 543 Week 3 example is built
The paper starts by explaining why the process needed drawing again, since staff sketches left out the loops. A section lists eight steps from order to report, each with its owner and a median time. Another names the three queues and their median waits, noting that afternoon orders often wait overnight. A section on the two loops gives their frequency: incomplete screening forms returned in 11 of 38 requests, and slots lost in 6 of 38. A section on where requests sit down summarizes the time spent waiting. The paper then contrasts the data-built map with what memory produced. It closes with limits, including the absence of weekend requests and the fact that timestamps record entry, not always the event itself.
NR 543 Week 3 rubric: what full points look like
Current state maps are generally judged on accuracy, completeness of steps and waits, use of real data, identification of rework loops and a clear account of what the map reveals. Maps that give median times for each queue, instead of an overall impression, show analytic care. Including loops, and how often they occur, separates a strong map from a tidy diagram of the intended process. Contrasting the map with staff expectations shows why mapping matters. A candid limits section, covering sample size, weekday bias and the meaning of timestamps, tends to earn credit rather than lose it. Citing lean or flow literature connects the work to the course. Instructors also value a map that a colleague could read without the writer present to explain it.
NR 543 Week 3 help from the desk
A frequent problem is mapping the process as policy describes it, which produces a straight line with no loops. Draw what the data show. Another is leaving out waits, so every step looks short and the total is unexplained. Give each queue a median. Students also map too many steps, burying the pattern; group minor actions and keep the main ones. Avoid labeling any step as the problem this week, since the bottleneck analysis comes later. Note where timestamps may mislead, such as a form completed long before it was signed. Keep the sample size honest and say which days it covers. Present the map as a table or figure with prose that walks the reader through it, and check that the step times add up to the totals you report.
Get a NR 543 Week 3 example written to your instructions
Send the assignment page, the rubric and any symbol set your section requires, and a finished Week 3 map with its prose comes back inside 24-48h. The first one is free. Tell us the process you have in mind and roughly how long the worst wait runs, and the example is drawn to that shape rather than a generic one.
More NR 543 papers and MSN samples
- NR 543 Week 1: Order to Scan Discussion
- NR 543 Week 2: Process Observation Notes
- NR 543 Week 4: Handoff Analysis
- NR 543 Week 5: Workaround Write-up
- NR 543 Week 6: Bottleneck Brief
- NR 543 Week 7: Future State Proposal
- NR 543 Week 8: Workflow Redesign Paper
- NR 542 Week 3: Database Structure Write-Up
- NR 541 Week 3: Consultation Write-Up
- NR 515 Week 3: Data Exchange Analysis, One Result
- NR 512 Week 3: Terminology Comparison for One Finding
NR 543 Week 3 questions, answered
Which diagramming tool do sections expect?
Most accept anything legible, including a drawing made in a word processor or on paper and photographed. Marks attach to the legend, the symbols and the durations rather than to the software. If your section names a specific notation, use it exactly, because the marker is often checking symbol use as its own line.
How detailed should the map be?
One box per action somebody performs, which usually produces a drawing of a couple of dozen boxes rather than five. Finer than that and the drawing becomes unreadable; coarser and the waits vanish inside the boxes, which defeats the point. If a box contains a wait, it is two boxes.
Does the map have to be of a real process?
Sections vary, and some supply a scenario precisely so that nobody has to watch a real one. Where you do map real work, keep the site, the staff and any patient out of the drawing entirely; a lane labeled by role and a unit described by type carry everything the assignment needs.
Where can I find a free NR 543 Week 3 sample paper?
The eight-step MRI map with its queues and loops is shown above as the NR 543 Week 3 sample, open to every visitor. If your process is different, share your steps and data and a current state map built on them can be prepared.
What should an NR 543 current state map include?
Each step with its owner and time, every queue with its median wait, any loops where work goes backward, and the total elapsed and work time. The sample shows three queues and two loops.