University Health Care Walk In Clinic Wait TIme Analysis Essay

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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
…show more content…
How cost effective is this considering the different service rates of MDs and NPs? (Assume NPs work 47 weeks per year.)
Salary for MD: $35-55K; salary for NP: $ 16-26K. We will use the midpoint salary of each for illustrative purposes.
Table 2

Service Rate Example
Midpoint Salary
Hrs/Yr
2080
Per Hr Rate
Pts/ Hr
Cost per Patient
MD
45,000
45k/2080=
$21.63
3.1
$21.63/3.1=$6.98
NP
21,000
21k/2080=
$10.10
1.8
$10.10/1.8=$5.61

The NP cost per patient is 80% of that of an MD ($5.61/$6.98 = 80%), but their visit volume per hour is 58% of the physician (1.8/3.1 = 58%).
Based upon service rates above, it is more cost effective for the physicians to see the patients.
If patients were truly offloaded to NP’s by the triage system it would be cost effective based upon the service rate. But this did not happen. In fact, the percent of patients seen by NPs decreased from 40% to 28%, and the percent patients seen by MDs increased from 41% to 48% (excluding patients that requested a particular provider).
5. What actions would you recommend to Ms. Angell?
a. Eliminate “walk in” appointments to relieve an obvious bottleneck.
b. Reassign the number of exam rooms to better optimize utilization and fulfill demand; MD cycle time is 19.4 minutes and NP cycle time is 32.8 minutes. Redirecting exam rooms to MD’s would also reduce the wait time for next available appointment thus improving patient satisfaction with wait time. For example,

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