Dr. Susan Fleishman is Medical Director of the Venice Family Clinic in Southern California (VFC). She is concerned about the long wait times of patients visiting the clinic and would like to improve operations. The situation is as follows: The patients are seen in the clinic be-tween the hours of 9: 00 a. m. and 12: 00 p. m. and between 1: 00 and 5: 00 p. m. The clinic sees, on average, 150 patients per day. Nine physicians are usually on duty to see patients during each clinic session. They are sup-ported by seven medical assistants who take vital signs and put patients in exam rooms. Four registration clerks are present to register patients, enroll them in federal and local aid programs, prep their medical records, and collect copayments. In addition, there are three coordinators who make follow- up appointments and arrange referrals, a security guard, a pharmacist, and two pharmacy technicians. The facility itself has a security widow at the front door with a guard- controlled entry door, a large waiting area, 5 registration windows, 11 exam rooms ( 3 of which are used for taking vitals), and 4 coordinator’s desks.

1. Draw a process flow diagram for each type of patient.

2. Calculate the capacity and utilization of each re-source and identify bottlenecks.

3. Calculate the average wait and time in service for new and returning patients with appointments and those returning for a prescription refill.

4. What are your recommendations for improvement?