Chapter $10$: Orthopedic Surgeon Case Study

Current Workload

Overview

Problem

Both surgeons working long hours

Do they need to hire more surgeons for the weekly workload they have?

Want $10\%$ safety capacity

David Christopher:

Orthopedic Surgeon

Surgery clinic of him

& one other surgeon

$12$ support personnel

Surgeries $5$ hours every morning, $4$ days$/$week

$7$am$-12$pm Monday$-$Thursday

Clinic hours from $1$pm$-6$pm

Monday$-$Thursday

Current workload $=2415$ minutes per week

How many surgeons?

Available Working Hours per Surgeon per Week:

Total Actual Available Hours with $10\%$ Safety Capacity:

$1$ surgeon x $5$ hrs$/$day x $4$ days$/$week x $60$ min$/$hr

$=1200$ minutes$/$surgeon$/$week

x $2$ surgeons $=2400$ min$/$week of available surgery time

$1200$ minutes$/$surgeon$/$week $120$ minutes

$=1080$ minutes per surgeon

$2400$ minutes $240$ minutes $=2160$ minutes per week available total

Safety Capacity:

a$.$ Hire one part time surgeon $($only mornings four days a week$)$

$3$ surgeons x $1080$ minutes$/$doctor$/$week $=3240$ minutes

b$.$ Hire one part time surgeon $(2$ mornings for a total of $10$ extra hrs$)$

$2\mathrm{.}5$ surgeons x $1080$ minutes$/$doctor$/$week $=2700$ minutes

$($These are too high for our needed capacity$)$

c$.$ Hire an extra surgeon only one day a week $($total of $5$ extra hrs$)$

$2\mathrm{.}25$ surgeons x $1080$ minutes$/$doctor$/$week $=2430$ minutes

$($This is closest to the $2415$ scheduled minutes and thus would have the least idle paid time$)$

Determining Ideal Number of Surgeons:

Demand $=2415$

Available hours $($with safety capacity$)$ per surgeon $=1080$

The $2415$ scheduled mins is above the $2400$ maximum capacity

$10\%$ safety capacity $=90\%$ utilization rate

$1200$ minutes x $0\mathrm{.}10=120$ min of safety capacity per doctor

$=240$ min total

$2415$ min$/$wk$/$surgeon $/1080$ min$/$wk$/$surgeon

$=2\mathrm{.}2361$ surgeons

Recommendations

Alternative C:

Other Alternatives to Optimize Throughput:

Alternative B:

Alternative A:

Lacking information:

on cost to hire extra doctor vs$.$ hiring extra surgeon

on how excess revenue earned from the extra surgeries would off$-$set the cost of another doctor or surgeon.

We assume:

more cost effective to hire a doctor $8$ hours$/$week compared to a surgeon for $5$ hours$/$week

that this is in an ideal world

Extend hours of surgery to $7$am $1$pm with lunch from $12$pm and maintain $10\%$

safety capacity:

$2$ surgeons x $6$ hr$/$day x $4$ days$/$wk x $60$ min$/$hr $=2880$ minutes per week

$2880$ x $0\mathrm{.}10=288$ minutes safety capacity

$2880288=2592$ minutes available surgery time

This results in $177$ more minutes than currently scheduled. Possible surgeries to schedule in this time:

$$ A knee surgery repair $(180$ minutes $$ would result in just under $10\%$ safety capacity

$$ Two extra rotator cuff surgeries $(180$ minutes$)$

$2$ extra ACL ligament repairs $(160$ minutes$)$

$$ Highest in demand, and still more than $10\%$ safety capacity

Maintain a $10\%$ safety capacity and $2$ surgeons, but schedule less surgeries:

$2415$ minutes scheduled $2160$ minutes available $=255$ minutes above capacity

If we take out a rotator cuff $(90$ minutes$)$ and $2$ ACL ligament repairs $(80$ minutes each$)$ this adds up to $250$ minutes, which is close to the $10\%$ safety capacity that we want.

Safety capacity $=12165$ minutes schedules$/2400$ minutes available x $100\%$

$=9\mathrm{.}792\%$

No extra surgeons $-$ use current two surgeons to capacity, but schedule

one less achillies tendon repair:

$2415$ minutes $50$ minutes $($achillies tendon repair$)$

$=2,365$ scheduled minutes

This results in approximate $1\mathrm{.}5\%$ safety capacity:

$12365$ min scheduled$/2400$ min available x $100\%=1\mathrm{.}458\%$

We recommend:

Alternative D

Alternative D:

Alternative C fails to support post$-$surgery patient care normally from $12-2$pm

Hire an additional doctor for the extra $2$ hours each day to take care of the patients normally scheduled for the surgeons during those hours.

Explain where the demand of $2415$ minutes is derived from?