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University Health Services

In: Business and Management

Submitted By cmdcock
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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 utilization of nurse practitioners = BEST WAY HOW? 1. The scope of ailments which the nurse practitioners may treat should be broadened: this will reduce the over-utilization of the physicians This recommendation asks for additional training or hiring nurse practitioners with more experience
2. Triage coordinators should not classify a patient with MD/NP. Otherwise what would be the...

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