Hacia una normalización de la representación de flujogramas en el ámbito hospitalario

This article presents a proposal of standardization for the representation of hospital protocols using flowcharts. In the clinical field, highly complex processes are typically developed. If these processes are not appropriately managed, fatal consequences for patients and the healthcare personnel could appear. Using a clear notation for modelling the tasks to be performed is mandatory to keep the risks under control. In practice, the most widely used flowchart language for years (due to its simplicity and versatility) is defined in ISO 5807:1985 standard. However, this language is insufficiently expressive to represent all the essential aspects of a health protocol. In recent years, this type of protocols has become increasingly sophisticated in order to improve the control of critical aspects that influence the safety of medicines, patients and practitioners. In this way, a widespread practice has been the implementation of the HACCP methodology for hazard analysis and control. During the modelling of these protocols (and because of the expressivity problems of traditional flowchart notation), each hospital has adopted its proposal that complements the elements included in the ISO (International Organization for Standardization) standard. This practice forces practitioners to become familiar with the ad-hoc defined notation for that center. In addition, these adaptations usually fall into ambiguous and non-formal definitions. In the standardization proposal presented in this article, new graphic stereotypes are introduced. These can be easily integrated into the ISO notation and are designed to represent the critical aspects of the HACCP (Hazard Analysis and Critical Control Points) plan. For the definition of these new elements, a series of requirements have been prioritized. First, it is taken into account the tools that are commonly used and the simplicity for final users. Moreover, it is mandatory to avoid ambiguities assuring that the introduced elements do not interfere with the base notation contained in the original ISO standard. This standardization proposal enriches the ISO5807:1985 language with expression mechanisms to represent essential information related to protocol security by reducing ambiguities and proposing a standardized notation.