Operations Presentation on the General Surgery Clinic at Boston Medical Center


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An operations management analysis of the surgical clinic at Boston Medical Center, quantifying current processes and giving recommendations for improving future performance.

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  • No issues with Material
  • No issue with ManpowerMaterialsMachineryManpowerMethodMeasure
  • Talk about how the data was collectedOur data points to a wide variation in the time it takes to complete each step in the process, largely because the process is different for each patient and because a lot is dependent on constantly changing variables, including available doctor and room capacity.Steps from check-in to triage to examination to consultation – point to wide variation along the way. Generally, long times both to wait for resident examination and for the examination itself.
  • Though our discussions with doctors and patients, we noticed that there were some differences between the amount of time a doctor expects to spend with a patient and the amount of time a patient expects to spend with a doctor. Because of their long list of patients, doctors aim to do the best job possible while simultaneously being efficient. This leads to them trying to spend a short period of time with each patient.The patient, on the other hand, expects that it will take a long period of time in order for the doctor’s examination to be thorough. According to our survey, patients expect to spend about 39 minutes with the medical staff, including triage, examination, and consultation. In reality, they spend about 23 minutes on average with the medical staff. This difference between the patient’s expectation, the doctor’s expectation, and the actual experience leads to a misalignment between the expectations of stakeholders.
  • Operations Presentation on the General Surgery Clinic at Boston Medical Center

    1. 1. General Surgery ClinicBMC<br />Operations Team 4<br />Asad Butt<br />EszterHamori<br />DineshKurian<br />Cristina Pedroza<br />Joel Samen<br />
    2. 2. Boston Medical Center (BMC) <br />“Exceptional care without exception”<br />Private Non-profit<br />Located in South End<br />BU’s Teaching Hospital<br />
    3. 3. Meet the Patients<br />
    4. 4. …Their Medical Concerns<br />
    5. 5. …And Medical Care Competitors<br />
    6. 6. Environment<br /><ul><li>Medical Assistants
    7. 7. Nurse Practitioners
    8. 8. Reception Staff
    9. 9. Attendings
    10. 10. Residents
    11. 11. Students
    12. 12. Patients
    13. 13. Examination Rooms</li></li></ul><li>Consultation Process<br />Patient´s Perspective<br />Patient is escorted to Examination Room<br />
    14. 14. Consultation Process<br />Staff´s Perspective<br />Medical Assistant<br />Resident Doctor<br />
    15. 15. Consultation Process<br />Staff´s Perspective<br />Attending Doctor<br />Wound Care Ostomy Nurse (Specialist)<br />
    16. 16. Why You Wait at the Doctor<br />
    17. 17. Issues with the Process<br />Throughput Time<br />Machinery<br />Measure<br />Variability in Demand<br />Non-English Speaking Patients<br />Patient Type<br />Case Type<br />Small Number of<br />Translator Phones<br />Attendings<br />Effectiveness vs. Efficiency<br />On the Job Learning<br />Shared Resources<br />Availability<br />Staff<br />Training<br />Program<br />Manpower<br />Method<br />
    18. 18. Absenteeism<br />Machinery<br />Measure<br />Socioeconomic<br />Factors<br />Transportation<br />Lack of Escort<br />Can´t Skip Work<br />No Car<br />Access to Public Transportation<br />No Children Care<br />Limited Parking<br />Limited / No-Coverage<br />Uncomfortable Seating<br />Dark, Boring, Narrow<br />Clinic <br />Premises<br />Insurance <br />Coverage<br />Materials<br />Method<br />
    19. 19. Expectation Misalignment<br />Measure<br />Measure<br />Data <br />Collection<br />Market Research<br />Customer Satisfaction<br />Survey<br />Benchmark<br />Lack of Process<br />Statistics<br />No Written Procedures<br />Disconnection with Top Management<br />Role Ambiguity<br />No Targets Set<br />Service <br />Guidelines<br />Staff Working <br />As a Silo<br />Method<br />Manpower<br />
    20. 20. Quality of Service: Process Specifications<br />
    21. 21. Quality of Service: Process Expectations<br />Doctor<br />Patient<br />Misalignment<br />Expectation:<br />To be simultaneously effective and efficient<br />Short time with each patient<br />Expectation:<br />Spend approximately 39 minutes with medical staff<br />25 Minutes with Medical Staff<br />
    22. 22. Recommendations<br />
    23. 23. Recommendation: Address No-Show Rate<br />
    24. 24. Recommendation: Reduce Schedule Variability<br />
    25. 25. Recommendation: Decrease Throughput Time<br />
    26. 26. Recommendation: Manage Expectations<br />
    27. 27. Recommendation: Improve Waiting Experience<br />
    28. 28. Creating a Better Patient Experience<br />Happier Patients<br />
    29. 29.
    30. 30. Appendix: Resident Time with Patient<br />
    31. 31. Appendix: Attending Time with Patient<br />