BUAD_311_West_Coast_Case_Analysis

West Coast University Student Health Services Primary Care Clinic:

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:

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:

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:

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 Friday MD 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 1 9-10am 6 5 1 6 5 1 7 2 1 7 4 1 6 5 1 10-11am 7 7 1 6 1 7 4 1 8 6 1 6 5 1 11-12am 7 7 1 6 5 1 7 4 1 8 6 1 6 5 1 12-1pm 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 2 2-3pm 8 6 2 6 5 1 5 4 2 7 5 1 8 5 2 3-4pm 8 6 2 6 5 1 5 4 2 7 5 1 8 5 2 4-5pm 8 6 1 6 5 1 5 3 1 7 5 1 8 5 2 sum(hr) 58 48 11 42 35 8 46 27 11 58 40 8 56 40 12 Allocation problem exists!!! I. Analysis of Current System

Current System – Problem with Scheduling (cont’d):

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:

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?:

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 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:

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:

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:

Looking back into Current System III. Measurement of Success

Looking back into Current System (cont’d):

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:

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]:

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):

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]:

Recommendation [2] Provide drinks, magazines, or even set TV in the waiting facilities Our rationale is: Unoccupied waits feels longer than occupied waits. 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

Slide 17:

End