Problem Set - 1

Solve the following problems using the Little’s law and assuming all the values
given are deterministic.
1. A hospital emergency room (ER) is currently organized so that all patients register through
an initial check-in process. At his or her turn, each patient is seen by a doctor and then
exits the process, either with a prescription or with admission to the hospital. Currently,
55 people per hour arrive at the ER, 10% of whom are admitted to the hospital. On
average, 7 people are waiting to be registered and 34 are registered and waiting to see a
doctor. The registration process takes, on average, 2 minutes per patient. Among patients
who receive prescriptions, average time spent with a doctor is 5 minutes. Among those
admitted to the hospital, average time is 30 minutes. On average, how long does a patient
spend in the ER? On average, how many patients are being examined by doctors? On
average, how many patients are in the ER? Assume the process to be stable; that is,
average inflow rate equals average outflow rate.

2. A triage system has been proposed for the ER described in the above problem. As
mentioned, 55 patients per hour arrive at the ER. Under the proposed triage plan, patients
who are entering will be registered as before. They will then be quickly examined by a
nurse practitioner who will classify them as Simple Prescriptions or Potential Admits.
While Simple Prescriptions will move onto an area staffed for regular care, Potential
Admits will be taken to the emergency area. Planners expect that, on average, 20 patients
will be waiting to register and 5 will be waiting to be seen by the triage nurse. Recall that
registration takes an average of 2 minutes per patient. The Triage nurse is expected to
take an average of 3 minutes per patient. Planners expect the Simple Prescriptions area
to have, on average, 15 patients waiting to be seen. As before, once a patient’s turn
comes, each will take 5 minutes of doctor’s time. The hospital anticipates that, on
average, emergency area will have only 1 patient waiting to be seen. As before, once that
patient’s turn comes, he or she will take 30 minutes of a doctor’s time. Assume that, as
before, 90% of all patients are Simple Prescriptions. Assume, too, that the triage nurse is
100% accurate in her classifications. Under the proposed plan, how long, on average, will
a patient spend in the ER? On average, how long will a Potential Admit spend in the ER?
On average, how many patients will be in ER?

3. Refer to problem 2. Once the triage system is put in place, it performs quite close to
expectations. All data confirm to planner’s expectations except for one set – the
 classifications made by the nurse practitioner. Assume that the triage nurse has been
sending 91% of all patients to the Simple Prescription area when in fact only 90% should
have been so classified. The remaining 1% is discovered when transferred to the
emergency area by a doctor. Assume all other information from problem 2 to be valid. On
average how long does a patient spend in the ER? On average how long does a Potential
Admit spend in the ER? On average how many patients are in the ER? Assume the process
to be stable; that is, average inflow rate equals average outflow rate.

4. 2-months into the operation, Kristen’s cookies have become campus favorite mid-night
snacks, so much so that, Kristen is able to pick and choose the type of orders she would
like to fulfill. In the meantime, Kristen and her roommate have realized that 1-dozen
cookie orders are reducing their profitability and decided to go with a minimum of two-
dozen orders from coming Monday onwards. Accordingly, they placed order for 2-dozen
and 3-dozen cookie boxes, which require only 2-minutes each to pack, irrespective of the
number of cookies. During the Sunday morning stroll, Kristen’s roommate came across a
Garage sale, where an oven of the same brand and capacity (as that of their oven in the
hostel room) and in good condition, was for sale at a throwaway price. Roommate
immediately called Kristen and by Sunday evening the sale oven was ready for use in
Kristen’s room along with their old oven. After baking a few dozen cookies in the second
oven, both roommates figured out that the capacity of the second oven is exactly same
as the first oven.

A week after they started using the two ovens and discontinued 1-dozen orders, Kristen
did some analysis of the past week’s sales data and found out that, on average 2/3 rds of
their orders were for 2-dozen cookies and 1/3rd orders were for 3-dozen cookies.

a) What is the bottleneck in the process, assuming they are still using single mixer for mixing
the dough and both Kristen and her roommate are helping each other out in their
designated jobs (e.g., Kristen accepts the payment, if her roommate is busy loading the
oven and the roommate helps Kristen by spooning a second tray of cookies whenever she
is free)?

b) What is the new theoretical capacity of the mixing, baking and labour operations?

c) Suppose the customers started complaining about the new 2-dozen and 3-dozen cookie
boxes and preferred old 1-dozen boxes to be more convenient. However, Kristen and her
roommate are a little skeptical about managing the operation with older 1-dozen boxes,
now that they have two ovens and the throughput rate has increased. Do you think they
will be able to manage the labour requirements between themselves with older 1-dozen
boxes?