Group 8 Xavier Mascarenhas Mathew Robert Jithu Pettan Renju Jose V Saravanan

University Health Services(UHS)

Medical Care to Harvard University students, staff, faculty

& their dependents

Prepaid system for over 90% of potential users

4 outpatient clinics including 1 walk in clinic

$ 10 mn total annual budget- 20% share of Walk In clinic

Walk In Clinic
37400 patients visited the Walk in clinic in 1979

Average of 143 patients per day

22 physicians, 2 registered nurses and 11 nurse practitioners

Pre Triage System

Sign In / AVF Form 2 min Retrieve and Send record 8.5 min Check Record 5 min

NP Wait-

7.5 - 19

N/S

24.5

NP/ MD

Treat Patient 32.8

SMD / SNP

Evaluation NP

Treat Patient 19.4

10

Triage System
Sign In / AVF Form 2 min Retrieve and Send record 8.5 min Check Record 5 min

Triage Patient
Triage Q Wait4.2 min

3.5 min

NP/ MD

Treat Patient
N:6.7 S:33.8

32.8

Treat Patient
N:25.2 S:33.8

19.4

Triage System Problems

Both system and

waiting time for all types of patients

increased
% of patients who wanted to be treated by a specific nurse or physician increased from 19% to 24% To avoid load during peak hours, triage coordinators started classifying patients as MD/NP increasing unnecessary load to MD

Walk In Appointments
Patients come for pre booked appointments to the Walk In

Clinic

This results in 2 out of 5 doctors being engaged in walk in

appointments

40% further reduction of available resources Waiting rooms are occupied by such patients Dissatisfaction of true walk in patients- they need to wait

for longer times if they want specific MD

Recommendations
Walk in commitments should be restricted to specific

slot so that the capacity can utilized properly

Triage nurses should not give the option of meeting

specific doctors- Aim is to provide best possible care to all the patients
Education of walk in patients is essential

Pre filling of request forms can be done on phone