MedNOW Clinic caseThe MedNOW clinic provides convenient healthcare services for a wide range of non-emergency medical issues. The clinic is located in Cambridge in close vicinity to a large hospital and serving a population with diverse ethnic backgrounds. Patients can walk-in or call in advance to schedule an appointment. The clinic operates 7AM to 7 PM on weekdays, with extended opening hours during the weekend. The clinic can do basic x-rays including chest x-ray and extremity x-rays (such as ankle, foot, arm and leg) and also provides lab services. On average 20 patients arrive at the clinic per hour, including walk-ins and appointments.Registration – The registration desk is continuously staffed with one person. They call the patient from the waiting room and create a patient record. The patient is then told to go back to the waiting room. The registration process takes on average one minute.Triage – The triage nurse calls the patients from the waiting room. They create a patient chart and register the check-in time. During triage the nurse determines the priority of patients’ treatments based on the severity of their condition. The triage is staffed with one registered nurse (RN) and the average time for triage is about 2 minutes. On average, 10% of the patients require medical care that is not available at the clinic and need to be sent to a hospital in the vicinity of the clinic. The other patients are told to go back to the waiting room and wait for the doctor call.Examination – The clinic has four examination rooms and four MDs available at all time. An assistant calls the patients into the examination rooms and help the patient prepare for the examination. The examination time is highly dependent on the medical condition. Based on historical records the clinic has determined the following distribution for examination time: Probability 0.4 0.4 0.2 Time 2 minutes 8 minutes 10 minutes In 50% of cases the MD completes the diagnosis, writes a prescription and the patient is ready to discharge. The other 50% of patients require some form of diagnostic and are sent to the medical diagnostic lab.Medical Diagnostics – There are three areas of medical diagnostic testing each with its own staff. Analysis of historical records produced the following information regarding demand for diagnostics and test time:
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