...University Health Services: Walk-In Clinic Evaluation of The Triage System Implementation ------------------------------------------------- Background and Introduction It had been 1 year after University Health Services (UHS) of Harvard implemented the triage system to improve its quality of service. During pre-triage system, the clinic got a lot of complaint from its patients mainly about the waiting time between sign-in and treatment as some patients (22%) had to wait more than 35 minutes to make first consultation with a nurse. In some cases, patients had to spent more than 55 minutes just to wait for a prescription renewal. Additionally, it was also reported that some patients cancelled their visits to the click due to long expected wait. Patients described the Walk-In Clinic as cold, inefficient and impersonal. Although the last statement could be debatable as the walk-in clinic is not intended as a personal and exclusive health services. Service evaluation identified that some procedures in pre-triage had contributed to the bottleneck and duplicate services which had caused longer waiting time for the patients. It was Kathryn Angell who was hired as assistant director for ambulatory care at the UHS proposed the triage system in order to improve the performance of the clinic in providing services for its patients. Some changes were made to better manage the service quality including to deploy two triage coordinators (selected from highly experienced registered nurses)...
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...Blackwell Clinic Khalil Blackwell Professor Lewis English Composition May 14, 2016 The Beginning of the Donelle K. Blackwell Clinic Greetings, I am Khalil Blackwell, your specialist for today’s discussion the upcoming construction of The Donelle K. Blackwell Clinic. A free clinic is defined as a hospital or health program, usually located in a neighborhood setting, that provides health care for ambulatory patients at minimal to no cost. Establishments such as these clinics provide service to an increasingly large group of citizens without health insurance. The Texas Medical Association’s census of the 2014 uninsured population shows that 23% of all adults age 19-64 do not have insurance. That is 9% higher than the nationwide average. These citizens do not have access to basic medical needs such as vital check-ups, cleanings or access to a medical professional that can accurately diagnose any illnesses or ailments. A free clinic such as this one can provide any non-insured adult access to these necessities. The intake process of this facility will be simple. With such a large of amount of uninsured patients in this particular community, having a long, drawn-out administrative process can cause extreme difficulties when trying to get all patients quality medical care. We first ask the potential patient to complete a simple application, providing the clinic with necessary personal information needed to continue with the services (i.e. Name...
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...University Health Services: Walk-In Clinic Pre-triage organization Organization: - 12 treatment rooms: 4 for nurses and 8 for doctors where 3 of these were permanently assigned to physicians as their UHS offices - Average of 143 patients a day the clinic was staffed on the basis of past experience with peak periods. Complaints: - Too long waiting time between sign-in and treatment - Length of wait not related to nature of visit - Inconsistency and too much variation in treatment between the different nurses - Duplicated efforts for patients who were seen by a nurse and a doctor Consequence: patients avoid visiting the Walk-In Clinic The triage system Differences with before: - Patients fill in an identification form which includes the reason for the visit - 2 triage coordinators briefly visit the patient and then conclude if the patient is more urgent than others: patients were only triaged to a nurse practitioner if their ailments fell under one of 13 categories. System didn’t work as well as they expected reasons? - Triage coordinators classified patients as MD/NP to maintain the flow - For one-third of the physicians more than 40% of their clinic patients requested them - Two of the five doctors are 100% occupied with walk-in appointments - Patient expects an atmosphere reminiscent of the country doctor’s office Angell’s dilemma: How can she improve the system? How to reduce waiting times and reduce complaints? - Hire more physicians - Increase...
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...University of Maryland Ambulatory Care Center: Highlighting Issues and Solutions DeVry University HSM 420: Managed Care and Health Insurance \ Introduction The quality of care is measured through the patient receiving the care. The patient measures quality of care through needs and preferences, care given without unnecessary delays and healthcare is not affected by gender, race, age or income. The Surgical Clinic at the University of Maryland strives to meet these goals by providing stellar care in a facility given the Leapfrog award for over a decade. Through observation there were a few areas in which could use improvement. Patients wait times affect how the patient perceives the care given. Another major issue is the need for consistency, reassurance to the patient that although the same physician may not be treating you during each visit the physicians are familiar with your individual case. Patients often find the location of the clinic difficult to find within the hospital which causes frustration upon arrival. The availability of clinics can cause an issue for patients. Description The University of Maryland Medical Center Surgical Clinic is governed by an ambulatory services team with different scopes of practice, including Doctors, Nurses, Administrators and other Clinical staff. The clinic staffs the Practice Manager, three subspecialty Nurses, a Medical Assistant, a Practice Assistant also the Scheduling Coordinator. The University of...
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...Family Heritage Assessment Stacey Bury, RN Grand Canyon University: Nursing 429V April 28, 2012 This paper will seek to understand 3 different cultures with utilization of the Heritage Assessment Tool. The purpose of the Heritage Asessment Tool in health promotion is to gain clarity on different cultures and their families. Increasing diversity of the United States (US) population is a reality in the 21st century. The Census 2000 indicates that one out of four persons in the US are non-Whites with Hispanic Americans constituting the largest (12.5% of total population) and fastest growing minority group. The Healthy People 2010 goal of “eliminating all health disparities” and the National Standards for Culturally and Linguistically Appropriate Services in Health Care highlight the need for all health care providers to be client-centered and cross-culturally competent. This necessitates health care professionals to be able to elicit, understand, and work with traditional health practices used by their clients. (Sankaran, 2007). Health care professionals can use the Heritage Assessment Tool to gain insight on cultural differneces within our society. The Heritage Assessment will not permit the resolution of all problems, but gives health care providers a view into families and how they deal with health issues. It is impossible to foresee all possible consequences of action, but ethical reasoning can facilitate appropriate and in-depth data gathering, permit the uncovering...
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...Needs to know ( About Free Clinics) Christy Phillips Strayer University English 115 ALENE Morrison 04/28/2014 The Public Needs to Know 2 The people in Douglasville, Georgia need to know that the health care of the community is crucial. It is because of the price of the insurance today too many people go without medical care that they need. If Douglasville, Georgia had a free clinic more people could get the health care of that they need. There are more people dieing everyday because they cannot afford to get the medical care they need. That is why now more than ever the community needs to open a free clinic here in Douglasville, Georgia for the low income families and the uninsured. The public needs to know why a free clinic would be beneficial to Douglasville, Georgia. To begin with the state of Georgia population is 9,687,953 and of that 132,493 live in Douglas county (US Census Bureau,2010). According to ( healthyfuturega.org) nearly 2 million people in Georgia are uninsured that is among the highest in the nation. There is a total of 44,131 uninsured in Douglas and Carroll County it is the third highest in the state of Georgia. The presence of free primary care clinic reduces hospital costs associated with non-urgent ED use and inpatient care (Journal of Health & Human Services Administration. Mar2012, Vol. 34 Issue 4, p456-470. 15p). That is why someone needs to find a way to help the uninsured and low income families get the health care they need. One of...
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...Running head: EXTERNAL AND INTERNAL ENVIRONEMNT External and Internal Environment Analysis Bharti Gupta University of Phoenix External and Internal Environment Analysis: Mayo Clinic The purpose of this paper is to analyze the External and Internal environmental factors of Mayo Clinic (MC). Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life (Mayo Clinic, 2011). Various types of external and internal factors affect the smooth flow of business at Mayo Clinic. External environment analysis is important in determining the strategy that should be adopted by a business and internal environment analysis is critical to identify the core competences of the business. External Environment External environment (EE) can be broadly classified into three types: Remote, Industry and Operating. Remote environment (sometimes called as macro environment) consists of the forces at work in the general business environment which will shape the industries and markets in which an organization competes (Stonehouse, Campbell, Prudie & Hamill, 2008). Industry environment (sometimes called as micro environment) is the competitive environment facing a business. It consists of the industries and markets in which the organization conducts its business competes (Stonehouse, Campbell, Prudie & Hamill, 2008). Operating environment also called the competitive or task environment comprises factors in the competitive situation...
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...Outpatient Orthopedic Clinic Thomas R. Rohleder, PhD Division of Health Care Policy and Research Mayo Clinic 200 First Street SW Rochester, Minnesota 55905 tel: 507-538-1532 Email: rohleder@mayo.edu Peter Lewkonia, MD Faculty of Medicine University of Calgary Calgary, Alberta Diane Bischak, PhD Haskayne School of Business University of Calgary Calgary, Alberta Paul Duffy, MD Faculty of Medicine University of Calgary Calgary, Alberta Rosa Hendijani Haskayne School of Business University of Calgary Calgary, Alberta July 2011 Abstract We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced. Keywords: Outpatient Clinic, Discrete Event Simulation, Process Improvement, Patient Waiting I. Introduction Visiting hospital outpatient clinics is a very common way for patients to access health care. These clinics typically schedule...
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...Orthopedic Clinic Thomas R. Rohleder, PhD Division of Health Care Policy and Research Mayo Clinic 200 First Street SW Rochester, Minnesota 55905 tel: 507-538-1532 Email: rohleder@mayo.edu Peter Lewkonia, MD Faculty of Medicine University of Calgary Calgary, Alberta Diane Bischak, PhD Haskayne School of Business University of Calgary Calgary, Alberta Paul Duffy, MD Faculty of Medicine University of Calgary Calgary, Alberta Rosa Hendijani Haskayne School of Business University of Calgary Calgary, Alberta July 2011 Abstract We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced. Keywords: Outpatient Clinic, Discrete Event Simulation, Process Improvement, Patient Waiting I. Introduction Visiting hospital outpatient clinics is a very common way for patients to access health care....
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...Outpatient Services and Primary Care Ambulatory care Outpatient services, including (1) care rendered to patients who come to physicians’ offices, outpatient departments of hospitals, and health centers to receive care; (2) outpatient services intended to serve the surrounding community (community medicine); and (3) certain services that are transported to the patient. Community-oriented primary care Health care that incorporates the elements of good primary care delivery and adds a population-based approach to identifying and addressing community health problems. Complementary and alternative medicine The broad domain of all health care resources other than those intrinsic to biomedicine. Gatekeeping The use of primary care physicians to coordinate health care services needed by an enrollee in a managed care plan. Hospice A cluster of special services for dying persons (those with a life expectancy of six months or less), which blends medical, spiritual, legal, financial, and family-support services. The venue can vary from a specialized facility to a nursing home to the patient’s own home. Medical home Patient-centered care based on the principles of the Chronic Care Model-that is, use of evidence-based guidelines, application of appropriate health information technology, and use of “best practices”-that seeks to consistently and reliably meet the needs of patients while being accountable for the quality and value of care provided. Outpatient Services provided while...
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... The fact that the physical therapy clinic where I used to work has recently lost three of the six technicians, it will not open management’s eyes to the need to re-evaluate some of their processes. It will not have any effect on the low pay they receive or the long hours they work. They will not take notice of the necessity to improve the worker to patient ratio or the poor lack of continuing job related education needed by their front line workers. Obviously the clinic is in business to make money but when it has an overwhelming, negative effect on the staff and the patients, the quality of service is severely impacted. There has to be a balance where profits are maximized as well as the quality of care to maintain at least a reasonable standard. The Institute of Medicine defines quality as: the degree to which health service for individuals and the populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. The Agency for Healthcare Research and Quality defines it in its simplest form: Doing the right thing at the right time in the right way for the right person and having the best result possible. ( Quality service is definitely important to people when it comes to their health. Most people are paying top dollar for those services and expect top service and results. People are tired of paying out their hard earned money for substandard treatment, goods and services. Repeat patients and referrals are...
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... The insurance applies statistical analysis to determine the chance that a particular event might occur to one of their customers. From this analysis they can determine the premiums which must be collected and the claims. Insurance is a very important part of modern life and business. Three health insurance companies: Healthspan, Anthem Blue Cross Blue Shield and Apex. Breaking down plans and talking about what they cover, how much they cost and where they are accepted and attempt to answer the age old question “Is people’s healthcare better depending on how much one pays?” All these packages are based on someone who makes $25,000 per year and only looking to cover just them. The prices also change depending on when they want their insurance to start and if they have to prorate for the previous month and also if the clients are a tobacco user or not. After reviewing all the information, people are not here to discredit the healthcare system, but open a few eyes to the harsh realities of hospitals Healthspan formally known as Kaiser is one of the most popular insurance companies that come to mind when people talk about insurance. People many pay more out of pocket but more of the services the client may...
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...Johnnese M. Jones Local Hospital Reviews MHA 5026 (u02a1) Dr. Beauvais October 20, 2013 Baylor Scott & White Health (Dallas, TX and Temple, TX) Scott and White Hospital was founded in 1904 by Dr. Scott and Dr. White and was named Temple Sanitarium. By 1922, Dr. White had passed away and the conversion of the hospital was changed to Scott & White Memorial Hospital. It has been comprised of the mission towards delivering an affordable, high quality of healthcare services to all the patients that walk through the doors of Scott and White. Recently, on September 30, 2013, the hospital merged with Baylor Health Care System in Dallas, TX to increase the spectrum of Healthcare in North and Central Texas. It consists of 43 hospitals and more than 500 patient care sites (Baylor Scott and White, 2013). Type of organization. General Hospital, Level 1 Trauma Center Tax Deductible, for example For Profit (FP) or Not for profit (NFP). Not for Profit (NFP) Key executive leaders. Drayton McLane, Jr. Chair Scott & White Jim Turner, Chairman Baylor Health Care System Joel Allison, CEO Baylor Scott White Health Dr. Robert Pryor, President & CFO Key Web sites www.sw.org, http://baylorscottandwhite.com/, http://www.baylorhealth.com/Pages/Default.aspx Basic market demographics, for example, target populations served. Target populations consist of the low income populations with Medicare and Medicaid of...
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...COMMUNITY REPORT: HENDERSON BEHAVIORAL HEALTH HISTORY: 1. Why was this organization established? To provide affordable psychiatric and casework services to residents of Broward County. 2. How did Henderson become a community mental health center? “During the late 1950's, the innovation of psychotropic medications revolutionized the mental health field. The Clinic became a multi-purpose organization with broad programs meeting the federal requirements of a community mental health center.” 3. Why was the center named “Henderson”? “In 1960, the late Mr. Alexander D. Henderson and his wife Lucy gave the Clinic stocks in Avon Products as well as property which is the current site of our "Central" Program on SW 27th Avenue in Fort Lauderdale. The money from the sale of the stock enabled us to build the structure and purchase the furnishings. The Clinic was renamed Henderson Clinic of Broward County in 1961.” 4. What populations does the center serve today? Henderson serves “more than 20,000 people of all ages, including 5,000 youth under 18 years of age.” FIND SERVICES CRISIS 5. What is the goal of Crisis Services? “ To provide immediate intervention to people experiencing a psychiatric crisis. Early intervention in a time of need can prevent hospitalization and stabilize acute situations. Crisis Services include mobile community outreach or walk-in services, psychiatric evaluation, consultation and medication monitoring, brief therapy, and...
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...Case report: Paediatric Orthopaedic Clinic 1- What is capacity utilization at every step in the process? What is the direct resource utilization? Using the data provided in the case, we are able to compile all data necessary to compute the capacity utilization at the clinic. Activity | # of Staff | Available time | Activity time | Number of Patients | Time needed | Utilization10 | | | /Staff | Total | N | F | N | F | N | F | Total | | 1. Front Desk | | | | | | | | | | | | a. Registration | 3 | 180 | 540 | 5 | 5 | 32 | 48 | 160 | 240 | 400 | 74 % | b. Verification | 3 | 255 | 765 | 9 | 4 | 32 | 48 | 288 | 192 | 480 | 63 % | 2. Radiology Department | | | | | | | | | | | | a. X-ray imaging | 6 | 240 | 9603 | 11 | 11 | 32 | 40.8 | 352 | 448.8 | 800.8 | 83 % | b. Development of X-rat | -1 | 240 | 9604 | 7 | 7 | 32 | 40.8 | 224 | 285.6 | 509.6 | 53%8 | c. Diagnostic reading and comments | 3 | 240 | 4805 | 5 | 5 | 32 | 40.8 | 160 | 204 | 364 | 76% | 3. Hand-off X-ray to Clinic | | | | | | | | | | | | a. Collection of X-ray | 3 | 2556 | 7657 | 2 | 2 | 32 | 40.8 | 64 | 81.6 | 145.6 | 19% 9 | b. Filing/exam room prep | 1 | 255 | 255 | 2 | 2 | 32 | 48 | 64 | 96 | 160 | 63% | 4. Examination Room | | | | | | | | | | | | a. Surgeon | 1 | 255 | 255 | 7 | 4 | 32 | 14.4 | 224 | 57.6 | 281.6 | 110% | b. Resident | 1(2)2 | 255 | 255 | - | 7 | - | 33.6 | - | 235.2 | 235.2 | 92% | c. Cast technician...
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