Question

Marion Health Clinic sees patients on a walk-in basis only. On average, 10 patients per hour enter the clinic. All patients register at the registration window with a registration clerk (RC), which takes 4 minutes. After registration, but before being seen by a nurse practitioner (NP), the registration records clerk (RRC) pulls the patient's records from the records room, which takes 6 minutes. At his or her turn, each patient then sees an NP, who checks weight, temperature, and blood pressure. This work activity takes 5 minutes. The NP determines if the patient must see a doctor (MD) or can be handled by a physician's assistant (PA). There is one MD, one PA, one NP, one RRC, one billing clerk (BC), and one RC in the system at the current time. The NP sends 40 percent of the patients to the PA and 60 percent to the MD. The PA takes on average 5 minutes per patient, whereas the MD takes 15 minutes. After the patient sees the PA or MD, the patient pays the bill or processes insurance information with the BC, which takes 3 minutes per patient. Then the patient exits the process Assume one person per stage in the process.

Answer 1

A) Correct process flow diagram is figure D

B) Throughput :

RC takes 4 minutes per patient. Therefore throughput of RC = 60/4 = 15 patients/ hour

RRC takes 6 minutes per patient. Therefore throughput = 60/6 = 10 patients/ hour

NP = 60/5 = 12 patients/hr

PA = 60/5 = 12 patients/hr

MD = 60/15 = 4 patients/hr

BC = 60/3 = 20 patients/hr

C) Labor utilisation rates :

RC = 10/15 = 66.7%

RRC = 10/10 = 100%

NP = 10/12 = 83.3%

PA = 10/12 * 40 = 33.3%

MD = 10/4 * 60 = 150%

BC = 10/20 = 50%

So, Bottle neck is at MD