Hospital Clinic Case

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after the patient would see the nurse and if the nurse could provide the necessary

treatment so the patient didn’t need to see the doctor, but if the patient needed to see the doctor

the patient returned to the waiting room and the nurse “put the medical record in a pile for the

doctors, again according to order of arrival. The patient was then seen by the first available

doctor” (page 3 of article). With this being said it would be easier after the patent is called and if

the nurse can seem to diagnose the problem then the patient should then wait in the room instead

of going back out to the waiting area to wait longer. When it comes to the nurses, they are only

there to help the doctor out before the doctor sees the patient. Nurses are there to weigh you,

check how tall you are, check blood pressure, heart rate, and ask you questions about your

symptoms and other general questions about the information you put on the form when you

check in. “All the nurses were involved in seeing all the patients initially. This created a bottle

neck” (page 3 of article). Along with the concept of a bottle neck the theory of constraint (TOC)

comes to mind. “This is done by identifying the bottleneck operations in the plan and increasing

the capacity of bottlenecks, often without buying more equipment but through more scheduling,

overtime, better workforce policies, and so forth” (page 253; Schroeder, R. and Goldstein, S.

(2017). Operations management in the supply chain. (7th ed.). New York, NY: McGraw-Hill

Education). With a bottleneck theory in a walk in clinic, it led to ”inconsistency and to much

variation in treatment, given the different skills and experience levels of individual nurses” (page

3). After the triage system was introduced it seemed to be about the same. “If the coordinator

decided the ailment warranted more immediate care, she put the patient ahead of others waiting

to see a doctor” (page 3 of article). When the triage system was put into place, was that “the

triage coordinator didn’t treat the patient but determined, according to the guidelines and her

discretion, whether the patient needed to see a nurse or a doctor in the walk in clinic or whether

the problem could be better handled by an appointment or referral to another UHS service” (page

4). When a patient comes to the clinic to be treated the nurse or the person who checks the

patient in should know right away how minor or major the patient is feeling.

According to the article it states “patients were triaged to a nurse practitioner if their

ailments fell under one of 13 categories (Exhibit 8; shown in the appendix). All ailments outside

these categories required the attention of a doctor, unless the triage nurse felt a nurse practitioner

could treat the problem” (page 4). It also states that it would be expanding the guidelines beyond

the 13 ailments would by state law require detailed treatment guides so that a nurse practitioner

could treat the patient without consulting a doctor. UHS planned such expansion in the future,

though it wasn’t known how many patients this might affect” (page 4). With this in mind, I

believe that this would be a good idea for the clinic to do. If the clinic did this it would allow the

nurses to treat more patients and it would also give the clinic to operate more on a smooth basis.

The last thing I would recommend is to expand the 13 nurse practitioner guidelines and

to further define the roles of the nurse praticioner and physician within the clinic. I say this

because “part of the problem is the general availability of appointment times. All our patients

have the freedom to select their own “personal physician” from among any of our doctors” (page

6). Even though we all have our favorite doctor that we like to see, they are always not available

when we wish to see them. My recommendation for the clinic would be to have the doctors be

filled in on the patients statuses. This way if the patient doesn’t get to see the doctor that they

want, their main doctor will fill the other doctor in about the patient.

If the clinic were to follow these recommendations and changes to their services I feel

that everything would go a lot smoother for them.

Appendix

Exhibit 5

Exhibit 4

Exhibit 8