Patient Flow in Waiting Room
Healthcare clinics are under a great deal of pressure to reduce costs and improve quality of service. In recent years, healthcare organizations have concentrated on preventive medicine practices and have tried to reduce the length of time that patients stay in a hospital. Outpatient services have gradually become an essential component of healthcare. Organizations that cannot make their outpatient component cost-effective are finding themselves financially burdened in this ever-changing industry (Caldwell, 2005).
Patient waiting times and waiting-room congestion in outpatient settings are two challenges facing the healthcare industry. Survey results indicate that excessive waiting time is often the major reason for patients' dissatisfaction with outpatient services. Waiting times of 10 to 15 minutes are considered reasonable.
Outpatient clinics are in essence queuing systems. These systems embody a unique set of conditions that must be considered when examining the appointment making procedure. Patient flow is simplified when scheduled patients arrive punctually and a single doctor serves them within predefined processing times. The flow gets more complicated when multiple doctors are involved or patients arrive late. Other factors that may complicate the flow are no-shows, walk-ins, and emergencies. In addition, doctors are sometimes delayed or interrupted throughout the course of the day by events not directly related to medical consultation.
The flow of an established patient in the waiting room is the subject of this process analysis. The process begins when the patient walks in the door. If the receptionist is not helping another patient, she greets the patient that has just walked in. The patient waits in line to check in with the receptionist (he or she enters the Arrival Queue). Once the patient reaches the desk, the receptionist asks if he/she has an appointment. If the patient does have an appointment, the receptionist "arrives" the patient, which consists of checking the patient into the computer system. Then, the receptionist checks the patient's demographics, which takes approximately two (2) minutes. Next, the receptionist asks if the patient has insurance. If the patient does have insurance, the receptionist collects their co-pay and asks them to take a seat and wait for their name to be called. If the patient does not have insurance, they are asked to fill out an eligibility waiver form (this takes five minutes), then asked to sit down. At this point, the patient enters the Waiting Queue, which acts as a buffer for the next stage of the patient flow: the medical consultation or examination itself.
If we were to conduct a back-of-the-envelope calculation on the average time that patients wait before entering the care process, it would result in approximately one hour for the average time. We can calculate this by adding the time it takes for the nurse to perform the triage (about 2-3 minutes), plus 10 minutes for the administration entry (registration). Then we need to average out the amount of time it takes to for someone to be assigned based on the different degrees of emergency. I.e. the first degree is immediate (zero minutes), the 2nd degree wait time is approximately 20 minutes, and the third degree average wait time is about 120 minutes (2 hours). If we take the average of these three we get approximately 47 minutes and we can add that onto the 12-13 minutes prior to get an average wait time of about one
Based on the data from Hospital Compare two of the measures that need some improvement are the patient experience and timely effective care, particularly the emergency department. These two measures are associated with the quality dimensions of timeliness and patient centerness. Timely and effective care can play
In the U.S and other nations of the world, the health expenditure and number of physicians increase as the economy expands. However, physician shortage is of a great concern globally, which the U.S and the Military Healthcare System (MHS) are no exceptions. According to Garber (2004) “a shortage exit when there is unsatisfied demand, which occurs when the quantity of a good or service is less than what people will be willing to buy at the current price”. For example a long wait time to get an elective surgery done, or a long wait for a patient to get an appointment to see the doctor are evidence of physician shortage. Another definition of shortage is “having a projected supply of physicians that meet less than 80% of the forecasted demand or need, calculated at the estimated means (Scheffler, Liu, Kinfu, & Dal Poz, 2007). The World Health Organization report (2006) estimated that, 57 countries had absolute shortage of 2.3 million physicians. This shortage according to prior studies implied the lack of a sufficient number of health care professionals to deliver skilled health interventions such as child-birth.
Because of the lack of organization with the health care providers in Canada, the wait times are too long and can cause serious complications to any condition the patient went in for in the first place. This situation of how the health care system can resolve wait times was brought to the government but they continue to ignore the proposals brought to them. It is possible to resolve the problems of wait times without extreme change and expenses in the health care system. The solution is to be found in the reorganization of the health care providers. Lack of assistance in the emergency room can make ones illness to become worse, therefore, causes the patient to be forced to wait in emergency rooms for an extended period of time and when they are finally seen by a health care provider, the outcome is very poor due to lack of registered staff, physicians and proper assessment(Goldman & Macpherson, 2005, p.40). The objective of this paper is to discuss and critically analyze the conditions of emergency waiting rooms. The specific issue this paper intends to explore is extensive and prolonged waiting times for patients accessing health care, patients who need urgent treatment and the vulnerability of elderly patients and children. With an in-depth critique of the barriers to health care and shortcomings of emergency rooms, strategies will be provided to enhance a health care system that makes it more accessible and efficient.
87). This study took a quantitative approach to show how the implementation of a fast track unit operated by a physician assistant could help to improve wait times for all acuity patients and improve length of stay for lower acuity patients (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 87). There is a literature review under the heading of introduction included in this article and a theoretical framework is also present; however, most resources that were cited are greater than 5 years old (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 87-88). Experimental design was used with this study since it examined the implementation of the fast track unit and then evaluation of the effects it had on wait times and length of stay (Keele, p. 41). A power analysis was used to determine sample size needed to show changes of 15 minutes or more in length of stay and wait times (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 89). The extraneous variables are number of complaints, mortality, acuity level, and presence of complex problems (Theunissen, Lardenoye, Hannemann, Gerritsen, Brink, & Poeze, p. 88-89). The data was collected from the E-care automated information system for emergency departments (Theunissen, Lardenoye,
Timeliness in medical care can be of the utmost importance. Letting things progress can result in a slippery circle, where a minor infection, untreated end up being life threatening. With increased damage caused by neglecting health care, or waiting on a health care provider, the physical damage, and costs associated increase, often exponentially.
Solution 1- In this method single batch process is followed in which a certain session block is assigned to the physician and the available session time is divided into intervals, and most of the patients are served before session ends. The major drawback in this system is interval length is not constant. Number of patients is the decision variable. Appointments are made on FIFO basis. It can be further categorized into single-block schedule and sequential block schedule.
... strategy, the outpatient clinic will benefit in several ways. Intra-departmental meetings will be held, both clinic and hospital staff will be present during such meetings. The staff at the clinic will no longer have to decipher through protocol; the outpatient clinic will be represented. This representation will make for a more productive staff. By making changes to the scheduling department and incorporating inter-departmental meetings, schedulers will have a greater respect for technologist’s workload. Customer service at the outpatient clinic will no longer suffer due to communication gaps. By implementing inter/intra-departmental meetings staff will be able to focus more on the patient and provide them with an overall better experience. By making these suggested changes the outpatient clinic will continue to grow and provide quality care to patients.
Emergency departments of hospitals are fundamental in the treatment of time sensitive conditions such as acute stroke (Trzeciak & Rivers, 2003). A stroke occurs when there is an interruption of blood flow to brain tissue, and therefore is a condition that relies on apt and adequate access to healthcare (Panagos, 2006). Patients who have experienced a stroke will most often present to emergency departments in order to receive treatment (Kothari et al, 1998). However it has been found by Chan et al (2010) that approximately 48% of American hospitals are operating over capacity and therefore not providing satisfactory healthcare. Overcrowding can be defined as the overabundance of patients requiring treatment and may be attributable to the misuse of the emergency area by non-critical patients (Chan et al, 2010; Trzeciak & Rivers, 2003). This has the potential to negatively affect outcomes for stroke patients. The aim of this essay is to investigate factors such as patient knowledge, wait times and patient safety in order to examine the effects of overcrowding of emergency departments on stroke patients.
V ́ericourt, F., & Jennings, O. B. (n.d.). Nurse-to-patient ratios in hospital staffing: a queuing perspective. Retrieved from https://faculty.fuqua.duke.edu/~fdv1/bio/ratios3.pdf
With the rapid growth of the healthcare industry, especially considering the recent on-going policy changes, it is no surprise to the general public that healthcare providers are spending less time with the patients. This is due to the broad spectrum of inattentiveness to healthcare quality. The Donabedian Model classifying healthcare quality is crucial in understanding the areas in which quality is present, or in this case, not present. As far as structures go, they are inherently involved as the environment in which patients are treated plays a significant role in satisfaction and overall outcome. The processes involving the provider and the patient are lacking necessary interpersonal relationships for physicians to effectively diagnose and treat patients. The current problem in healthcare quality is the lack of patient centeredness in ambulatory care. This problem is resulting in low patient satisfaction and sub-optimal outcomes from discrepancies in care.
The film, “The Waiting Room,” is a documentary that records the events at a public emergency room over the course of 24 hours. It reveals testimonials of both patients and workers throughout their stressful and unpredictable days.
Quality patient care is an ongoing endeavor that involves many different areas of healthcare. One area of healthcare that is often employed is Utilization Management. We read in John’s that UM “is composed of a set of processes used to determine the appropriateness of medical services provided during specific episodes of care” (John,2011). Things that are used to determine the appropriateness of care include the patient’s diagnosis, site of care, length of stay, and other clinical factors. This system consists of three main functions aimed at improving patient care and controlling healthcare costs. These functions include utilization review, case management, and discharge planning. One source states that it also includes the claim denials and appeals process (Interviewee C. Jarvis, e-mail communication, May 3, 2014). When used correctly, these UM processes can expedite the patient’s care and reimbursement. It also demonstrates to third party payers that the organization is taking measures to help control costs. This monitoring and management of patient healthcare needs ensur...
When scheduling a patient for a diagnostic procedure or laboratory test, it is often easier for the physician’s office to schedule the appointment than to have the patient schedule it. Before scheduling a procedure for a patient, the medical assistant needs to compile the information that needs to be relayed to the outside facility. The critical information needed for scheduling a patient procedure includes:
The QTSPlus is a simulation procedure that is used for single-server or multiple-servers settings (Siew, Pooi, & Tan, 2014). With this queuing system, M/G/c/c module in QTSPlus was implemented to find the capacity size that can cover a target patient time. The M/M/c module in QTSPlus was used to estimate the effect of the distribution of beds with poison arrival and service rate with multiple