University Health Care Walk In Clinic Wait TIme Analysis
UHS Walk-In Clinic Case Analysis
1. Draw a process flow diagram of the post-triage system. Compare waiting times for the pre-triage and the post-triage systems. Is the new system an improvement over the old?
See Flow Chart attached.
No, it did not improve the process. The new triage did not meet the intended goals of off-loading patients to NPs and the overall throughput time did not change.
2. Analyze the available MD and NP capacity. How effective is the clinic in matching supply and demand?
Table 1
Daily Average: 143 visits
MD
8a – 6p (10h)
Provider Cycle Time
Room Availability
Visit Capacity
Capacity Utilization
8 rooms
3 / 22 MD’s =13.6% (1-.136) or 86.4%
**Estimate of % time all 8 rooms available
19.4 min/visit
8*.136 = 1.088
5*.864 = 4.32
Wt Avg of room availabililty:
5.4 M.D.rooms
5.4*(10h*60m/h)
19.4
167 MD visits/day
143 * .67 =95.81 / 167
57.3%
**MD sees 67% of visits
NP rooms
8a – 6p (10h)
4 rooms
32.8 min/visit
4.0 N.P. rooms
4*(10h*60m/h)
32.8
73 NP visits/day 143 * .33 =47.19 / 73 64.6%
**NP sees 33% of visits
NP’s have a slightly higher utilization 64.6% vs. MD’s at 57.3%. At this time, based upon the arrival rates (Exhibit 2) and our average daily completed patient visits, UHS Walk-In Clinic is meeting the demand.
3. Comment very briefly on the "walk-in appointments" phenomenon. Why are these walk-in appointments a problem?
The “walk-in appointments” add variability to the triage system and create a new bottleneck. In addition to occupying the walk-in slots, the patients that “walk in” and request a specific provider wait an average of 8.6 minutes longer than the “true” walk-ins. The triage process is the same for “true” walk-ins and “appointment” walk-ins but they require more physical space, staff time and queue time. The “walk-in appointments” decrease the available MD walk-in appointments, increase wait time, occupy valuable clinic space, and
1. Draw a process flow diagram of the post-triage system. Compare waiting times for the pre-triage and the post-triage systems. Is the new system an improvement over the old?
See Flow Chart attached.
No, it did not improve the process. The new triage did not meet the intended goals of off-loading patients to NPs and the overall throughput time did not change.
2. Analyze the available MD and NP capacity. How effective is the clinic in matching supply and demand?
Table 1
Daily Average: 143 visits
MD
8a – 6p (10h)
Provider Cycle Time
Room Availability
Visit Capacity
Capacity Utilization
8 rooms
3 / 22 MD’s =13.6% (1-.136) or 86.4%
**Estimate of % time all 8 rooms available
19.4 min/visit
8*.136 = 1.088
5*.864 = 4.32
Wt Avg of room availabililty:
5.4 M.D.rooms
5.4*(10h*60m/h)
19.4
167 MD visits/day
143 * .67 =95.81 / 167
57.3%
**MD sees 67% of visits
NP rooms
8a – 6p (10h)
4 rooms
32.8 min/visit
4.0 N.P. rooms
4*(10h*60m/h)
32.8
73 NP visits/day 143 * .33 =47.19 / 73 64.6%
**NP sees 33% of visits
NP’s have a slightly higher utilization 64.6% vs. MD’s at 57.3%. At this time, based upon the arrival rates (Exhibit 2) and our average daily completed patient visits, UHS Walk-In Clinic is meeting the demand.
3. Comment very briefly on the "walk-in appointments" phenomenon. Why are these walk-in appointments a problem?
The “walk-in appointments” add variability to the triage system and create a new bottleneck. In addition to occupying the walk-in slots, the patients that “walk in” and request a specific provider wait an average of 8.6 minutes longer than the “true” walk-ins. The triage process is the same for “true” walk-ins and “appointment” walk-ins but they require more physical space, staff time and queue time. The “walk-in appointments” decrease the available MD walk-in appointments, increase wait time, occupy valuable clinic space, and