Small Ponds College
Clinic Small Ponds College operates a walk–in medical clinic to meet the acute medical needs of its students, faculty and staff members, and covered relatives. Patients arriving at the clinic are served on a first–come, first–served basis.
Upon arriving at the clinic, patients receive a form from the receptionist seeking basic biographical information and the nature of the medical condition for which treatment is being sought. Completing the form typically takes 6 minutes, and requires receptionist oversight during that time.
After the form is completed, it is time–stamped and placed in a tray. Forms remain in the tray for about 5 minutes before the receptionist retrieves the patient’s medical records. This retrieval task takes 4 minutes. After a patient’s medical records file is retrieved, the form describing the medical problem is appended to it, and it is placed in a stack with other files. The stack of files is ordered per the time stamps on the forms. When a nurse practitioner (NP) finishes with their current patient, they select the next file from the stack and escort that patient to one of the treatment rooms.
Files remain in the stack for about 10 minutes.
Once in the treatment room, the NP reads over the form describing the patient’s ailment, discusses the problem with the patient, and takes standard measurements including blood pressure and temperature. The NP then makes a rough diagnosis, based on the measurements and symptoms, to determine if the ailment is treatable by an NP. All this takes about 10 minutes. State law identifies ailment types which NPs are permitted to treat. If the condition is treatable by an
NP, then a more thorough diagnosis is undertaken and treatment is prescribed. It typically takes 15 minutes for the NP to complete the detailed diagnosis and
discuss the treatment with the patient. If the condition, as roughly diagnosed, is not treatable by the NP, then the patient’s file is placed in the stack for a physician (MD). Patients wait an average of 20 minutes for an MD. Given their higher training and skill, MDs are able to diagnose and treat patients in 15 minutes, despite dealing with more difficult, less routine cases. Thirty patients arrive each hour, of which 30% are seen by an MD. There are 2 receptionists, 3 MDs and 12 NPs.
Questions (show your work)
1. Draw a process flow diagram for the medical clinic.
2. How many patient flow paths did you find?
3. How long does it take for a patient to get in and out of this clinic?
4. What is the capacity utilization of Receptionists, MDs and NPs? What do you conclude from these values (what observations do you draw, what recommendations might you make)?
5. To achieve 100% utilization of Receptionists, MDs and NPs, how many Receptionists, MDs and NPs are needed?
6. The management of Small Ponds College Clinic is exploring an idea intended to help improve long–term patient care. They propose that 50% of all the patients that are seen by an MD, after being seen by the MD, must then meet with an NP for a short counseling session. The NP counseling session takes 6 minutes, and is preceded by a 4 minute wait. Provide your analysis of this process change.
