buad 311 west_coast_case_analysis
TRANSCRIPT
West Coast University
Student Health Services Primary Care Clinic
Group members:(Ariel) Jingyi Lai(Iris) Tong Wu
(Janette) Hei Man Leung(Lucy) Qian Ye
(Tina) Yuet Ki Wong
Background Information
Primary Care Clinic (PCC) Central medical facility Appointment / Walk-in System Staffing:
Nurse Practitioners (NP): 5 full-time & 3 part-time Medical Doctors (MD): 5 full-time & 4 part-time Medical Assistants (MA): 6 Support Staff: 1
Brief Summary
From Patient Satisfaction Survey Excessive waiting time Difficulty in scheduling
appointments High return rate Impersonal bureaucracy Non-users: 29.4% Favored (Low
perception of service qualification)
Mission: To provide better and higher quality of services by allowing patients to pick a primary care clinician as their “own doctor”. However, problems start floating up…
Current System – Problem with Scheduling
Clinicians per hour chart: number of clinicians for each time slot Based on the schedule
Total available time of NPs in a week = 11400 min Total available time of MDs in a week = 15600min
Monday Tuesday Wednesday Thursday FridayMD NP MA MD NP MA MD NP MA MD NP MA MD NP MA
8-9am 6 5 1 0 0 1 5 2 1 7 4 1 6 5 19-
10am 6 5 1 6 5 1 7 2 1 7 4 1 6 5 110-
11am 7 7 1 6 1 7 4 1 8 6 1 6 5 111-
12am 7 7 1 6 5 1 7 4 1 8 6 1 6 5 112-1pm 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1-2pm 8 6 2 6 5 1 5 4 2 7 5 1 8 5 22-3pm 8 6 2 6 5 1 5 4 2 7 5 1 8 5 23-4pm 8 6 2 6 5 1 5 4 2 7 5 1 8 5 24-5pm 8 6 1 6 5 1 5 3 1 7 5 1 8 5 2sum(hr
) 58 48 11 42 35 8 46 27 11 58 40 8 56 40 12
Allocation proble
m exists!!!
I. Analysis of Current System
Actual Capacity
NP capacity for 6 months=11400 minutes*26week=296400 minutes
Demanded Capacity
MD capacity required: 9005 patients*25 minutes per patient=225125 minutes
NP capacity required: 6760 patients*25 minutes per patient=169000 minutes
MD capacity for 6 months=15600 minutes*26week=405600 minutes
Current System – Problem with Scheduling (cont’d)
I. Analysis of Current System
Proper Capacity Calculation Criteria
Utilization for MD = 225125/405600 = 55.55% Utilization for NP = 169000/296400 = 57.02% Average utilization: (0.5555042+0.57017544)/2 = 56.26% Arrivals per hour (1/a) = (9005+6760)/26 weeks/ 5 days per
week/8 hours per day = 15.158654 customers per hour Inter arrival time (a) = 60 minutes/ 15.158654 patients per hour
= 3.95814 minutes Process rate (1/p) = 2.4 patient per hour (P=25 minutes per
patient) Processing time (p) = 25 minutes
I. Analysis of Current System
Is there enough capacity?
Yes. Since both utilization rates weigh below the full
capacity, there was indeed enough capacity. Clinicians were not the bottleneck resource.
Long waiting time was mainly caused by patient’s random arrivals.
I. Analysis of Current System
Proposed System
Proposed Strategies: Teams of MDs and NPs Assign pool medical assistants to deal with records
Goals: Total waiting time of 20 minutes or less Less than 5% of patients unable to see their specific team
when they came to the walk-in clinic The maximum delay for seeing a team clinician should be
one day
II. Analysis of Proposed System
Drawbacks of Proposed System
Elevator becomes bottleneck This increases the amount of time needed to
get around the building
Teaming leads to dissatisfaction from employees
Unspecified teams lead to poor perception and insecureness of service
II. Analysis of Proposed System
Critical Measure of Success
Since survey indicates satisfaction of patients are closely related to waiting time, our critical measure of the effectiveness of the system would then be the average waiting time of patients.
III. Measurement of Success
Looking back into Current System
III. Measurement of Success
Looking back into Current System (cont’d)
Average waiting time ≈ 0.5 minute Assumption: Patients arrived evenly throughout the day and
employees are all properly allocated. Patients theoretically should not complain. Truth: patients are more likely to arrive before 3pm At least one server is idle for 90% WASTE!
High return rate of current system Current system failed to accommodate patient’s first
preference for clinicians
Rate of patients getting preferred clinician should also be a measure of success
III. Measurement of Success
Key Takeaway from the Current System
Measure of Success Average waiting time of patients, and Rate of patients getting their preferred clinician
OUR PRIORITY IS TO COME UP WITH BETTER SCHEDULING OF CLINICIANS AND ALLOCATION OF RESOURCES
III. Measurement of Success
Recommendation [1]
Our rationale is: Since employees are not fully utilized, we should allocate resources well so that they are consistent with the needs of patients. And based on previous analysis, our focus would be on MDs and NPs.
We agree on teaming up MDs and NPs, however ways in constructing teams is more essential.
IV. Our Recommendations
Recommendation [1] (cont’d)
The construction of team would be as follow: Before 3pm (high demand): A total of 13 MD and NP per
hour After rush hour: A total of 6 MD and NP per hour
Impact: Improve waiting time of PPC Concerns over overall quality of team work and other
factors have to be taken into account Implication: Plan has to be revised and updated timely
for best results
IV. Our Recommendations
Recommendation [2]
1) Provide drinks, magazines, or even set TV in the waiting facilities
Our rationale is: Unoccupied waits feels longer than occupied waits.
2) Set an ask desk to help explain the process in system and give information about waiting time
Our rationale is: Providing the estimated waiting time and a fair environment can give patients a sense of fairness and security.
In order to change patients’ perception of waiting time better manage the process, and increase the overall customers’ satisfaction, the following measures can be taken:
IV. Our Recommendations
End