1. Suppose the office implements a process change by using an RN to perform some of the surgeon’s work. Specifically, for a plagiocephaly exam, the surgeon’s time decreases from 18 to 10 minutes, while the RN’s time increases from 23 to 35 minutes. In addition, for a craniosynostosis exam, the surgeon’s time decreases from 40 to 22 minutes, while the RN’s time increases from 23 to 40 minutes. Assuming only the numbers of surgeons and RNs are adjusted in response to the process changes, how will this change the staffing levels and total cost for the outpatient office?

Resource	Surgeon	ASR	RN	CA
Weeks per year	52	52	52	52
Less: Vacation & Holidays	6	4	4	4
Less: Training and Leave	2	2	2	2
Available weeks per year	44	46	46	46
Hours per day	10	8	8	8
Less: Breaks, training, meetings	1.2	1.5	1.5	1.5
Available hours	8.8	6.5	6.5	6.5
Cllinical minutes available per day
Clinical minutes available per year

 

Annual Cost per person	$         696,960	$ 89,700	$ 134,550	$ 71,760
Capacity cost rate ($ per minute)

 

Personnel process times (minutes)
Plagiocephaly	18	8	23	5
Neoplasm skin excision	22	55.5	20	5
Craniosynostosis	40	10.5	23	10

 

 

Plastic Surgery Dept.
Charges	$ 12,449,500
Costs	7,469,700
Reimbursement	7,967,680
RCC: Ratio of costs-to-charges

 

Total cost	Charge	Average reimbur sement	TDABC Profit	RCC Cost	RCC Profit
$          -	$ 350		$      -		$      -
$          -	$ 350		$      -		$      -
$          -	$ 350		$      -		$      -