Paediatric Orthopaedic Clinic Case Study

Topics: Physician, Patient, Hospital Pages: 11 (580 words) Published: July 14, 2015
Paediatric Orthopaedic Clinic
Case Study
David F. Marte
Eastern University
Operation Management
Professor Ted Shemella


The Pediatric Orthopaedic Clinic at the
Children’s Hospital of Western Ontario
provides specialized pediatric services to
children living around or near Ontario,
Canada. After rising complaints about the
patient wait times, Dr. Kellie Leitch
reviewed the data collected from patients,
to identify the process and look for ways
to reduce the waiting times.

Activity Utilization

In order to calculate the utilization rates, data that
was retrieved and analyzed from patient surveys
and time studies. Utilization rates were calculated
as separate divisions and by the particular job
title. To calculate the utilization rates for
individual job functions, the number of total hours
spent on the process was divided by the number
of total hours available for work for the particular
worker(s). Doing so, utilization rates were 74.07%
for clerks, 81.83% for the main three nurses,
83.42% for technicians, 75.83% for radiologist,
57.25% for the extra nurse, 110.43% for the
surgeon, 92.24% for the senior resident, and
90.04% for the cast technician (Appendix A).

Appendix A

Activity Utilization

Similarly, to calculate the utilization rate
for individual divisions, the number of
total hours spent in the division was
divided by the number of total available
hours for that division. The corresponding
utilization rates for the divisions were
67.43% for reception/front desk, 69.83%
for radiology, 28.63% for x-ray hand off,
and 97.57% for examination room
(Appendix B).

Appendix B

Bottleneck & Capacity Constraints

When looking to the bottleneck in the process,
things to be considered where wait times and
utilization rates. Using this logic, we determined
that there may be bottlenecks in the radiology
department and the examination room. In the
radiology department, the patient wait time is
almost double that of the other wait time. In the
examination room, it was observed that the staff
are over utilized or close to being utilized; the
surgeon’s utilization is over 110%. The bottleneck
has been determined to be the examination room,
where the surgeon in particular has been working
over capacity at over 110%. The examination
room is also the capacity constraint because it
limits the throughout.

Improvements to Consider

Change of Hours of Operation
One of the biggest complaints by parents is that
they are losing money by foregoing work to take
their children to the hospital. By changing the hours
of operation to later in the day where the average
parent is finished with work, it would help eliminate
the economic cost of coming to the doctor. It may
also help improve waiting times since the hospital
may not be as busy later in the day.

Improvements to Consider

Upgrade Equipment
Although there is a high upfront cost to
additional equipment, it should still be
considered because of the improvement it
will have in patient satisfaction and
reducing lead times. The clinic must weigh
the value of improved satisfaction with the
economic costs of purchasing the additional

Improvements to Consider

Patients who live far away should be allowed to get
x-rays done somewhere closer to them to reduce the
amount of time they have to wait when they do get
to the clinic. Similarly, once the initial diagnosis and
tests are conducted, the clinic should recommend
other clinics or physicians to conduct follow-up
appointments. This would reduce the number of
patients the surgeon would see and thus he/she will
not be over utilized.


Schroeder, Goldstein &
Rungtusanatham – Pages 459-464.

References: 
Schroeder, Goldstein &
Rungtusanatham – Pages 459-464.
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