University Health Services: Walk-in Clinic

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University Health Services: Walk-in Clinic

  1. Process Flow

PRE TRIAGE FLOW CHART

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  TRIAGE FLOW CHART
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  |                          |Pre-Triage                                               |Triage                                                   | |                    |NP             |MD           |SP/MD       |SP/NP               |NP           |MD                   |SP/MD             | |8am-9am             |18.2           |12.2         |2           |6.1                 |19.4         |3.1                   |197.1             | |9am-10am             |17.6           |11.8         |2.5         |4.7                 |19.4         |3.1                   |152.5             | |10am-11am           |16.8           |11.3         |5           |2.3                 |19.4         |3.1                   |72.8               | |11am-12pm           |15.2           |10.2         |3           |3.4                 |19.4         |3.1                   |109.8             | |12pm-1pm             |11.8           |7.9         |3           |2.6                 |19.4         |3.1                   |85.2               | |1pm-2pm             |16.9           |11.3         |3           |3.8                 |19.4         |3.1                   |122.0             | |2pm-3pm             |16.2           |10.9         |3           |3.6                 |19.4         |3.1                   |117.0             | |3pm-4pm             |15.9           |10.7         |4           |2.7                 |19.4         |3.1                   |86.1               | |4pm-5pm             |11.6           |7.8         |3           |2.6                 |19.4         |3.1                   |83.8               |

Calculation in Table:
Total # of patients: taken form Exhibit 2
# that see MD: (67/100)x Total # of patients
# of MDs: taken from Exhibit 4
patients / MD = # that see MD /# of MDs
Time per patient: taken from Exhibit 5
Patients/hour = 60min/ Time per patient
Capacity Utilization = (patients / MD) / (Patients/hour)

d)   Capacity Utilization by Week

  | # of Patients |# to MD |# to NP |MD hours/day |NP hours/day |Des. Cap MD |Des. Cap. NP |CU MD |CU NP | |Monday |163 |109.2 |53.8 |29.5 |31.5 |91.5 |56.7 |119.4 |94.9 | |Tuesday |151 |101.2 |49.8 |28 |31.5 |86.8 |56.7 |116.6 |87.9 | |Wednesday |136 |91.1 |44.9 |28 |31.5 |86.8 |56.7 |105.0 |79.2 | |Thursday |137 |91.8 |45.2 |28.5 |31.5 |88.4 |56.7 |103.9 |79.7 | |Friday |128 |85.8 |42.2 |31 |31.5 |96.1 |56.7 |89.2 |74.5 | | Calculation in Table:

# of Patients = taken from exhibit 2
# to MD = 0.67 x # of Patients
# to NP = 0.33 x # of Patients
MD and NP hours/day = taken from Exhibit 4 by totaling each column Design capacity MD= 3.1 (# of patient seen per hour) x MD hours per day Design capacity NP = 1.8 (# of patient seen per hour) x NP hours per day Capacity Utilization (CU) MD = # to MD/ Design capacity MD

Capacity Utilization (CU) NP = # to NP/ Design capacity NP

e) By decreasing the record retrieval and checking time the total time for the first patient that arrives each day would decrease but it would not change the total wait for subsequent patients.   The treatment of patients either by and NP or MD serves as a block as they are the most time consuming of all process in the flow through of patients.

Observation, Conclusions, Recommendations
Capacity Utilization of triage nurses on a daily basis is 59%.   Triage nurses are able to take on 41% more work i.e. a total of 97 more patients and maintain an efficient rate of operation. From the patient arrival information in Exhibit 2, we notice that Mondays has the highest patient load and Fridays the least. This effects the capacity utilization of medical staff i.e the higher the volume of patients the higher the utilization.   The lowest utilization during the day it at the end of the day between 4 and 5:30pm.

If all other points in the process had to be left unchanged then one way to increase efficiency at the...
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