Clinic Workflow — Master Flowchart

This workflow illustrates the end-to-end patient journey through The Sandusky Dyslipidemia Model clinic, from referral receipt to ongoing management. For detailed documentation of each step, see the corresponding clinical documents linked below.

How to Read These Charts

The workflow is split into three charts that follow the patient in order. A dashed box at the end of a chart names the chart that picks up from there.

Entry point or goal reached Assessment step Decision question Treatment started or test ordered Caution: needs further evaluation High risk: urgent or aggressive action Labs, scheduling, or administrative step Continues in another chart on this page On a small screen, swipe sideways on a chart to see all of it.

Part 1 — Referral and Scheduling

flowchart TD
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    classDef assess fill:#264653,stroke:#16303a,color:#fff
    classDef treat fill:#1565c0,stroke:#0d47a1,color:#fff
    classDef caution fill:#c2410c,stroke:#9a3412,color:#fff
    classDef urgent fill:#b42318,stroke:#7a1a12,color:#fff
    classDef admin fill:#5f6770,stroke:#454c53,color:#fff
    classDef link fill:#fff,stroke:#264653,stroke-width:2px,stroke-dasharray:5 4,color:#264653

    A[Referral Received]:::entry --> B{Eligibility<br>Screen}
    B -->|Meets criteria| C[Schedule New<br>Patient Visit]:::admin
    B -->|Does not meet<br>criteria| D[Return to Referring<br>Provider with Explanation]:::admin

    C --> E{Priority<br>Assessment}
    E -->|Urgent: LDL ≥190,<br>post-ACS, TG ≥500| F[Schedule within<br>2 weeks]:::urgent
    E -->|Standard| G[Schedule within<br>4–6 weeks]:::admin

    F --> H[Pre-Visit:<br>Patient Instructions]:::admin
    G --> H

    H --> I[Nursing Intake<br>10 min]:::admin
    I --> J[Provider Encounter<br>25 min]:::assess
    J --> NEXT[Continue to Part 2:<br>Initial Visit]:::link

Part 2 — Initial Visit and Treatment Plan

flowchart TD
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    classDef assess fill:#264653,stroke:#16303a,color:#fff
    classDef treat fill:#1565c0,stroke:#0d47a1,color:#fff
    classDef caution fill:#c2410c,stroke:#9a3412,color:#fff
    classDef urgent fill:#b42318,stroke:#7a1a12,color:#fff
    classDef admin fill:#5f6770,stroke:#454c53,color:#fff
    classDef link fill:#fff,stroke:#264653,stroke-width:2px,stroke-dasharray:5 4,color:#264653

    J[Provider Encounter<br>25 min]:::assess --> K[History &<br>Physical Exam]:::assess
    K --> L[Review Available<br>Labs & Records]:::assess
    L --> M[Document Risk<br>Factors & Enhancers]:::assess

    M --> N[PREVENT Risk<br>Calculation]:::assess
    N --> O{Risk Category<br>Assignment}

    O -->|Low risk<br>CAC=0 + ApoB neg| P[Consider<br>De-risking]:::entry
    O -->|Borderline/<br>Intermediate| Q[Evaluate Risk<br>Enhancers]:::caution
    O -->|High/Very High<br>or ASCVD| R[Aggressive<br>Treatment]:::urgent

    P --> S[Lifestyle<br>Counseling]:::assess
    Q --> T{Advanced Testing<br>Indicated?}
    R --> U[Initiate/Optimize<br>Pharmacotherapy]:::treat

    T -->|Yes| V[Order Advanced<br>Tools]:::treat
    T -->|No| U
    V --> W["ApoB / NMR /<br>Lp(a) / CAC"]:::assess
    W --> X[Reassess Risk<br>Category]:::assess
    X --> U

    U --> Y[Treatment Plan<br>Documented]:::treat
    S --> Y

    Y --> Z[Order Labs for<br>Next Visit]:::admin
    Z --> AA[Schedule<br>Follow-Up]:::admin
    AA --> NEXT[Continue to Part 3:<br>Follow-Up Cycle]:::link

Part 3 — Follow-Up Cycle

flowchart TD
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    classDef assess fill:#264653,stroke:#16303a,color:#fff
    classDef treat fill:#1565c0,stroke:#0d47a1,color:#fff
    classDef caution fill:#c2410c,stroke:#9a3412,color:#fff
    classDef urgent fill:#b42318,stroke:#7a1a12,color:#fff
    classDef admin fill:#5f6770,stroke:#454c53,color:#fff
    classDef link fill:#fff,stroke:#264653,stroke-width:2px,stroke-dasharray:5 4,color:#264653

    AA[Schedule<br>Follow-Up]:::admin --> AB{Follow-Up<br>Type}
    AB -->|New med or<br>dose change| AC[4–8 weeks]:::admin
    AB -->|Titrating,<br>not stable| AD[3–6 months]:::admin
    AB -->|At goal,<br>stable| AE[Annually]:::admin

    AC --> AF[Follow-Up Visit<br>20 min]:::assess
    AD --> AF
    AE --> AF

    AF --> AG{At Treatment<br>Goal?}
    AG -->|Yes| AH[Continue Current<br>Therapy]:::entry
    AG -->|No| AI[Escalate per<br>Treatment Pathway]:::caution

    AH --> AA
    AI --> U[Back to Part 2:<br>Initiate/Optimize<br>Pharmacotherapy]:::link

Workflow Cross-References

Workflow Step	Detailed Documentation
Eligibility Screen	02 — Patient Eligibility
History & Physical Exam	03 — Initial Assessment, Sections 2.0–4.0
PREVENT Risk Calculation	04 — Risk Stratification
Risk Category Assignment	04 — Risk Stratification
Advanced Tools	06 — Advanced Tools
Treatment Plan	05 — Treatment Pathways
Follow-Up Protocol	12 — Follow-Up Protocol

Special Pathways

The following specialty pathways branch from the master workflow at specific decision points:

Pathway	Entry Point	Flowchart
Familial Hypercholesterolemia	LDL-C ≥ 190, tendon xanthomas, or family history of FH	FH Pathway Flow
Statin Intolerance	Reported statin intolerance during history or treatment	Statin Intolerance Flow
Treatment Escalation	Not at goal after initial or adjusted therapy	Treatment Escalation Flow
Risk Stratification Detail	PREVENT calculation and advanced testing decisions	Risk Stratification Flow
Advanced Tools Decision	Which advanced test to order and when	Advanced Tools Decision Flow

Version History

Version	Date	Description
1.0.0	2026-03-30	Initial release
1.1.0	2026-09-29	Split into smaller charts so text renders at full size; fixed line breaks that printed as literal escape codes; accessible color palette and shared legend