What delays the transition from intake to a decision on next steps?
The review examined why some referrals do not move promptly from intake to a documented decision on next steps, and what could be examined to improve this transition.
ORGANIZATION
Ofek Employment Rehabilitation Center
Fictional name
UNIT AND PROCESS
Intake team
From case opening to a decision on next steps
DATA PERIOD
March–May 2026
REPORT DATE
18 June 2026
Date within the fictional example
Sample report. All data is simulated.
This fictional report illustrates the structure of ALNA's planned first-pilot deliverable. The organization, figures, descriptions and findings are fictional. They are not client results or evidence of functionality already operating in the system. No personal or medical information is included.
Fictional figure
What it describes
Scope and source
41 of 68
Referrals that reached a decision on next steps within 14 working days of case opening
Average time from case opening to placement, among referrals placed by the end of the period
Background figure, beyond the review boundary · Source 5
Summary
CHAPTER 01
What was found
The reviewed documents did not explicitly define who is responsible for closing the handoff, and some records lack documentation of case receipt. Information does not move consistently. The transition between assessment and the decision on next steps is a possible point of delay; this needs confirmation using timing data between stages.
Main possible explanation
Uncertainty about who is responsible for the transfer, what information must accompany it and when it counts as complete. This is a hypothesis supported by the findings, not a causal conclusion.
What remains open
How much of the delay reflects increased workload and insufficient capacity, and how much reflects unclear responsibility. Response times from external referrers were not examined.
REPORT STATUS · ACTION DIRECTION FOR EXAMINATION
There is a basis for examining a limited action direction. More capacity information is needed before deciding on a wider scope. The report distinguishes this status from “more information needed” and “insufficient basis for a recommendation.” It does not record an organizational approval.
PROPOSED NEXT STEP FOR DISCUSSION
Consider examining a named responsible role and acknowledgment of receipt at each transfer between assessment and the decision on next steps in one team, while completing capacity data by program.
Process Map
CHAPTER 02
Stage
Roles
Review focus
1. Inquiry or referral
Administration, intake coordinator
2. Intake and case opening
Intake coordinator
3. Initial assessment
Intake coordinator, professional assessor
Selected transition for examination
4. Decision on next steps
Program coordinator, assessor
Selected transition for examination
5. Placement
Placement coordinator
6. Start of participation
Employment instructor
The highlighted stages mark the point of friction selected for examination. In this fictional example, the map was built from the procedure and forms and confirmed in writing with the organizational contact. Other teams were not examined.
1. Responsibility for closing the handoff is not explicitly defined
OPERATIONAL DATA · DOCUMENT
Observed: The reviewed documents did not explicitly define the responsible role; the procedure assigns the transition to “the team.” In 27 of 68 records, receipt of the case is not documented.
Meaning: The transition may depend on individual initiative rather than an explicit definition.
Still unknown: Whether missing documentation reflects a transfer that did not happen, or one that happened but was not recorded.
2. Information does not move consistently
DOCUMENT · AGGREGATE SUMMARY
Observed: In 4 of 10 cases reviewed internally by the organization, the receiving role sought further clarification of information. The assessment form has no field for the agreed next step. ALNA received only an aggregate summary, not the individual case files.
Meaning: Missing information may contribute to repeated work and delay.
Still unknown: Whether the gap reflects the absence of a template or insufficient time to complete it.
3. Staff report workload pressure and manual tracking
STAFF REPORTS · OPERATIONAL DATA
Observed: 6 of 9 frontline respondents maintain personal tracking outside the system; 3 of 9 indicated that responsibility for the transition is clear. Cases per coordinator rose from 22 to 31 between December 2025 and May 2026.
Meaning: Some workload may stem from unclear responsibility, and some from an actual increase in work volume.
Still unknown: The relative contribution of each.
Evidence types
Operational data shows what was recorded. Documents show how the process is intended to work. Staff reports reflect perceptions and experience; they do not measure what happened in each case.
Protecting respondents
The middle-management and leadership questionnaires each received fewer than five responses, so their results are not displayed. They were used only to check whether themes found in other sources also appeared there.
Main Possible Explanation
CHAPTER 04
Hypothesis: The findings raise the possibility that unclear transfer responsibility, required information and confirmation of completion contribute to reliance on personal initiative and memory. This explanation needs to be examined alongside workload and capacity. It is not a proven cause.
WHAT SUPPORTS IT
Receipt is not documented in 27 of 68 records. Source 5
The procedure does not explicitly define a responsible role for the transition. Source 3
Further information clarification after assessment. Source 6
Most frontline respondents report personal tracking. Source 1
WHAT CHALLENGES IT OR SUPPORTS AN ALTERNATIVE
Workload and capacity: cases per coordinator increased over the period. Source 7
To examine: is there a wait for placement?
To examine: does coordination with the service user contribute to delay?
MISSING INFORMATION
Timing between stages, to confirm the point of delay
Availability by program and role
Response times from external referrers
Variation between teams
Whether missing documentation indicates a transfer that did not happen
Action Options for Examination
CHAPTER 05
Three options based on the findings. They are not ranked and may be combined. The decision is made with the organization; no option is recorded as selected or approved.
A · A responsible role and acknowledgment of receipt at every transfer
Link to finding and explanation
Finding 1 · Directly addresses the main hypothesis
Conditions for carrying it out
A leading role, one team and an agreed deadline for acknowledgment
Workload and resources
A brief action at every transfer, without procurement
Risks
Technical acknowledgment without substance; workload shifted to the receiving role
Needed for a decision
Who leads, in which team, and how the receiving role's workload is checked
B · A short information checklist accompanying the case
Link to finding and explanation
Finding 2
Conditions for carrying it out
Agreement on essential fields and adaptation to the existing form
Workload and resources
Preparing a template and completing it at every transfer
Risks
An additional form that adds burden and is not completed
Needed for a decision
Which fields are essential and who approves the template
C · A weekly review of cases that have not moved forward
Link to finding and explanation
Findings 1 and 3
Conditions for carrying it out
An up-to-date list and a regular weekly review time
Workload and resources
Regular weekly time for the program coordinator
Risks
The review may be perceived as monitoring individual staff
Needed for a decision
Who coordinates it, and whether the review remains at team level only
Required before expansion
Availability data by program and role. Without it, we cannot know whether an action focused on clarity would be sufficient; expansion to additional teams should therefore not be recommended.
Not proposed at this stage
A new tracking system or automation. The findings suggest possible lack of clarity in the definition of, and responsibility for, the transition. A tool managing an undefined process could entrench that lack of clarity.
Conclusions and Limitations
CHAPTER 06
WHAT CAN BE SAID
The documents did not explicitly define who closes the handoff or what information accompanies it.
The transition between assessment and decision is a possible point of delay.
There is a basis for examining a limited, testable action direction.
WHAT CANNOT YET BE CONCLUDED
That unclear responsibility caused the delay. This is a supported hypothesis.
That delay is concentrated at this point, before checking timing between stages.
The relative contribution of insufficient capacity and unclear responsibility.
That cases without documentation were not transferred.
What service users experienced. Direct feedback was not collected.
What the Organization Is Asked to Do
CHAPTER 07
Confirm: that the map and findings reflect actual work.
Correct: facts that are inaccurate or missing.
Decide: whether to examine an action direction and whether to complete missing information.
Topic
Decision
Owner
Date
Confirmation of map and findings
Action direction to examine
Completing capacity data
Next step
This table is for completion during discussion with the organization. It does not record decisions already made. No implementation duration, owner, target or approval has been agreed in this example.
If Further Work Is Agreed: What to Measure
CHAPTER 08
Type
Measure
Baseline in this fictional example
Implementation Did the action take place?
Records without documentation of case receipt
27 of 68
Transfers acknowledged within one working day
Not measured. This must not be treated as zero.
Outcome Did anything change?
Referrals reaching a decision on next steps within 14 working days
41 of 68
Average time from case opening to placement, among referrals placed by the end of the period Background figure, beyond the review boundary
19.4 working days
Check implementation before outcome. A before-and-after change alone does not prove that the action caused it. These values describe the simulated diagnostic baseline; no implementation or post-intervention outcome has been measured in this example.
The report in ALNA's learning cycle
Stage
Scope in the example
Understanding the process and information
Part of the first-pilot diagnostic illustrated here
Diagnosis and examination
Part of the first-pilot diagnostic illustrated here
Choosing an action direction
Requires separate agreement
Implementation and monitoring
Requires separate agreement
Review and learning
Requires separate agreement
Updating the evidence base
Requires separate agreement
The map and findings are retained. In a subsequent cycle, their current relevance is checked and new observations are added. Implementing a change and reviewing it in another cycle would be defined by separate agreement.
Appendix · Sources and Basis for Action Options
CHAPTER 09
All sources below belong to the fictional example. They are not documents or records from a real client.
1. Frontline staff questionnaire
Staff reports · May 2026 · 9 responses
Questionnaire dated 12 May 2026
Gaps and limitations: No gap specified for this source.
2. Middle-management and leadership questionnaires
Staff reports · May 2026 · Fewer than five responses in each group
Questionnaires dated 12 May 2026
Gaps and limitations: Results are not displayed as separate groups.
3. Intake procedure
Document · 6 pages
Version 2.1, 2024
Gaps and limitations: No responsible role for the transition.
4. Blank intake and assessment forms
Document · 3 forms
Undated
Gaps and limitations: No field for the next step.
5. Referral and transition data
Operational data · March–May 2026 · 68 referrals
Extracted 1 June 2026
Gaps and limitations: Incomplete documentation of ownership.
6. Aggregate summary of the organization's internal review
Aggregate summary · March–May 2026 · 10 cases
Production date not specified
Gaps and limitations: Small sample. The organization carried out an internal review and supplied only an aggregate summary; individual case files were not sent to ALNA.
7. Capacity data
Operational data · December 2025–May 2026 · Cases per coordinator by month
Production date not specified
Gaps and limitations: No availability data by program.
8. Process map
Working document · Confirmed in writing
2 June 2026
Gaps and limitations: One team only.
Basis for the action options
Organizational evidence
Findings 1–3 and sources 1, 3–7.
Relevant professional knowledge
Established process-management principles concerning responsibility at handoff points. No specific research source is cited, so these action options are not presented as research-based.
Fit considerations
Limited scope, no procurement, no changes to job descriptions, and the ability to stop without significant cost.
How to read the report
A finding is what was observed, with a source. A possible explanation is a hypothesis. An action direction is a proposal to examine. A decision is made by the organization.
Group results are displayed only when there are at least five responses. Smaller groups have no percentages, quotations or detailed breakdowns.
“Not measured” is not zero. Missing documentation is not proof that an action did not happen.
Missing information is stated alongside its limit on inference. If it is essential to a decision, the process must not proceed as though it had been received.
Sample report. The organization, numbers and descriptions are simulated and written solely for illustration. They are not client outcomes or proof of functionality already operating in the system. There is no personal or medical information in this report.
Preparation and approval. In the planned process, ALNA will connect the sources and prepare a draft. AI tools will assist with processing and wording; they are neither an information source nor an approving authority. Shani Shimshian will review and professionally approve the report before delivery.
An illustration of the planned first-pilot report
Implementation and review in a subsequent learning cycle require separate agreement. This example contains no completed organizational decisions, implementation activity or measured post-intervention results.
