Currently, many processes in the clinic are conducted serially, without overlap. A possible method to reduce wait time is for the MA to inform the when they are about to bring the patient in for vitals. By allowing tasks to be conducted in parallel [4][5], nurses can enter the room while the MA is still present to seek consent for the procedure. This eliminates the wait time for nurse consent and MA prep for procedure since the MA will not leave the room. Longer MA Wait Times on Mondays, Tuesdays and Wednesdays The team advises the clinic to further investigate the longer wait times on Mondays, Tuesdays and Wednesdays. One way to approach the issue would be to revise staffing levels on the stated days to cope with the larger number of patients. Another approach would be to reassign the providers away from the first three days, to Thursday and Friday, to smoothen out the demand for MAs and therefore, reduce MA wait times. Long Nurse Wait Times Nurses at the urology clinic have to attend to both scheduled nurse visits and assist providers in procedures, obtaining consent and patient teaching. Currently the nurses are assigned to providers and assist whichever provider they are assigned to. One recommendation would be to assign nurses to roles rather than providers. By assigning a portion of nurses to assisting providers and another portion to nurse visits, the team hypothesizes that there would be less wait time for nurses. To confirm this hypothesis, a pilot study would have to be conducted after the change to verify the result. PSA Patients Spend Longer Times at the Clinic The team proposes a follow up on PSA patients to clearly identify the reason why they are spending longer times in the clinic. Scheduling of PSA patients may have to be different from other diagnosis depending on the result of the follow-up study. Excess Wait Times for MAs The long wait time for MAs is a huge opportunity for improvement for the urology clinic. One of the more pertinent issues is the long MA wait times at the start of the clinic. The team recommends that the clinic either allow appointments to begin at 8:30 AM instead of 8:00 AM, to allow for more time to prepare the exam rooms at the start of the day, or adjust staffing at the start of the day to reduce wait times. The team also recommends looking into the assignment of
Appendix C: Data Analysis Charts Appendix C-:1: Kruskal-Wallis test output on the time spent in clinic by diagnosis types. Source: Michart Data from 11/2/15 - 10/31/16, N = 7500; 1 = Stones, 2 = Benign Prostatic Hyperplasia, 3 = Urinary Tract Infection and Cysts. 4 = Incontinence, 5 = Erectile Dysfunction, 6 = Elevated PSA, 7 = Hematuria Patient Waited >5 mins for MA -Time difference between pre-arrival time and the time the patient left the desk if patients were early (>5 minutes before pre-arrival). Time difference between the later of actual time patient left front desk and the time the patient was received by the MA for vitals if patients were punctual or late. >60 minutes time in clinic - Time difference between pre-arrival time and actual time the patient left the clinic. Wait time >5 minutes for Provider - Time difference between time provider sees the patient and time of the last patient staff interaction. This metric only applies for instances when patients were ready for the provider at the scheduled appointment time (+/- 5 minutes of arrival time).