University Health Services: Walk-in Clinic

we could change the appointment system so a Gp each morning would have no appointment s booked in advance they would see every patient that needed to be seen between the times of 8:00 and 11:00 this way the patient would be seen within the expected time of 48 hours,

As the population ever increases doctors are being over stretched more than ever meaning every appointment slot is valuable, GP 's are then forced to discharged patients that repeatedly offend for missing appointments which leads to complaints, thus creating more work for the surgery staff and doctors! Then when the said patient applies to re-register at the surgery or applies to register at a different surgery more man hours are consumed.

Per week each surgeon should work 1200 minutes a week, a combined 2400 minutes, to have a 10% safety capacity, meaning that the two surgeons are really only going 15 minutes above the recommended time. If each surgeon works 1200 minutes a week that means there should be about two hours per surgeon for a safety capacity. The total available hours per surgeon with the safety capacity in effect is 1080 minutes per week, or 2160 minutes between them. So if the demand for the clinic is 2415 minutes, and each surgeon with the 10% safety capacity can work 1080 minutes per week, then the

By increasing the number of beds by 50%, the total number of beds available would become 135 (90 x 1.5 = 135 beds). As a result, Shouldice Hospital could perform a maximum of 45 operations per day before running out of bed capacity. With operations still being performed 5 days per week, the total bed capacity would become 675 beds (135 beds x 5 days a week = 675 beds). In relation to the current operation of 30 patients per day, the utilization rate for bed capacity would now be 66.67% (450 / 675 = 66.67%).

The health facility in this case study experienced several problems and issues beyond possible solution efforts by the time. One of the main problems is based on the perfect way of handling the various challenges attributed to a shift from the hospital’s fee-for-service in the case of managing care environment. Besides, some local physicians were loyal to Dr. William and had the necessary flexibility and availability to assist the doctor in various ways, but today they are no longer available to assist the doctor towards the achievement of his medical and societal mission. The physicians were always available and loyal to the doctor and they could volunteer their efforts especially in cases of physician shortages in the health center. The physicians cannot afford the time they once used for volunteering activities in the health facility to assist Dr. Williams (Swayne, 2008). The reason behind this problem is that the physicians have now been employed by various managed health care organizations. Others have been involved in various contractual agreements such that the partners prohibit them from working with the health care facility. Although the health care facility has a few small groups or individuals offering primary care, these individuals and small groups are still struggling to survive in the industry. As such, the majority of them cannot

The most difficult items to project were patient visits because they are vital to the entire process since they dictate the electricity, salaries and wages, malpractice insurance, water, and supplies. It is not an easy task to guess how many patients will need to be seen since we do not know what the geographical location is of the clinic or what the year will bring in outbreaks or illnesses. How sick a patient is or what illnesses are prevalent during that time period is not something that the clinic can control. Also the clinic has been very understaffed the past couple years so with the hopefully influx in patients there would need to be an increase in administrative and medical staff. The items that would cause the most risk if mis-estimated would be malpractice insurance, salaries and wages, and number of visits. If they miscalculate the number of visits then this could hinder the other categories which would result in a possible shut down of clinic if not enough malpractice insurance is counted for and staff and personnel would leave if they were not being paid appropriately due to the miscalculation of patient visits.

Appropriate nurse staffing is a complex topic that has arisen as a nationwide healthcare issue within the profession of Registered Nurses (RN). To truly understand the concept of staffing one must understand that staffing and scheduling are often at times used interchangeably although Mensik (2014) noted a distinct difference between the two (p. 2). The American Nurse Association [ANA] (2012) has defined appropriate nurse staffing “as a match of registered nurse expertise with the needs of the recipient of nursing care services in the context of the practice setting and situation” (p. 6). Scheduling, in contrast, involves taking into account factors such as a unit’s historical census numbers along with anticipated surgical volumes

Moreover, the office visit length will be shortened due to the high demand of customers making it harder to provide good quality of care to patients as well . On the other hand, from the physician point of view it is predictable that doctors will change practice patterns from private offices to hospital services because the facilities pay salaries with less expectations in the number of patients seen per day. Furthermore, due to the elevated number of patients, time left for clinical documentation and record keeping will be nulle.

Healthcare just like any other type of service industry is reliant on possessing satisfied clientele. Scheduling practices help to manage the patient flow by establishing certain guidelines regarding how late a patient can arrive, and still be seen without disrupting the patient flow

How cost effective is this considering the different service rates of MDs and NPs? (Assume NPs work 47 weeks per year.)

Another threat is the current state of rural hospitals nationwide. According to the case study, about 25% of Americans live in rural areas and only about 10% of physicians actually practice in rural areas. There is a 15% gap in the ratio of rural citizens to available practicing physicians. This is a threat to ELH’s need to attract and hire more physicians. In relation to rural hospitals, citizens have longer drive times to their medical facilities. This causes them to delay routine visits which subsequently exacerbates

Develop a similar room-occupancy table to show the effects of adding operations on Saturday. (Assume that30 operations would still be performed each day.) How would this affect the utilization of the bed capacity? Isthere sufficient capacity for the additional patients?

Within the case, The Carbondale Clinic, it is apparent that a scheduling problem exists which has then resulted in patients being unsatisfied with the amount of time they must wait to be seen for his or her scheduled appointment with the physician. It is also evident that physicians prefer to have a full schedule without taking into consideration the possibility of emergencies that may arise throughout the day that will contribute to patients having to wait even longer. It is pertinent that the manager sits down with the staff to determine what is the most logical solution to help resolve the scheduling problem, taking into consideration what the physicians want along with ensuring patient satisfaction.

The hospital is currently utilizing 71.43% of their beds, this is actually an ideal operating point. To increase its rate of utilization might decrease the service quality.

Several existing problems precipitated the creation of the triage system implemented by Kathryn Angell in an effort to deliver improved medical care. The main problem was a lack of coordination in service delivery. This lack of coordination caused excessive wait times on the order of anywhere from 23 to 40 minutes to see a nurse, 40 to 50 minutes to see a doctor, and as long as 55 minutes to get a prescription filled. The practice of all nurses being involved initially in seeing all patients caused duplication of efforts, including repeating questions and examinations, and resulted in procedural bottlenecks. Additionally, there were inconsistent levels of service and extreme variation in treatment because of the different experience