The wait times for patient exams at a medical oncology practice increased from an average of 13 minutes to 31 minutes after adding 3 new doctors. Various data analyses were performed to understand the sources of increased wait times and identify opportunities for improvement. Potential solutions identified include increasing the number of patients scheduled per time slot and hiring additional phlebotomists. Further data collection and process changes will aim to reduce wait times while maintaining high patient throughput.

1. Wait Time
Reduction Project
By Andrew Phillips
July 16, 2012

2. Situation
 Three (3) new Medical Oncologists (Doctors) joined the practice six weeks ago,
increasing the number of Medical Oncologists at the Practice from 5 to 8. Since the
addition of the 3 new oncologists, patient wait times for Exam visits have risen sharply
from an average of 13 minutes to 31 minutes. This is a 140% increase.
 Reduce average wait time to x number of minutes (see what the customer would like
to see as a minimum, an average, and maximum wait time.)
 The patients are scheduled in 15 minute intervals for each physician.
 There was increase from 140 to 224 opportunities for patients. This represents a 60%
increase in patient load.
 Assumption: Percentage of the number of patients per physician was constant.
 The laboratory employs 3 full time phlebotomists who draw blood, and each draw takes
7.5 minutes on average.
 Assumption: The Laboratory will need another 10 minutes to deliver the results to the
physician.
Copyright © 2010 US Oncology, Inc. All rights reserved. 2

3. Problem
 The patients have complained about the increase wait time.
 This backlog increases throughout the day which causes
overtime and working through lunch and breaks.
 Patients may leave, causing decrease in revenue.
 Workers are overworked.
Copyright © 2010 US Oncology, Inc. All rights reserved.

4. Measurements
 Using Lean Six Sigma tool set of statistics analysis see how to
better manage the patient flow and find solutions
 Map the process with Swim lanes.
 Develop a CTQ tree to see what is important to the customers
 Measure Lab process times and the time it takes to get the data
to the physician.
 Individual Moving Range (IMR) chart – showing the variance in
the process and how we can reduce the variance. This is using
variable data and sample size of 1.
 Measure the wait times more closely and see if there is a
correlation between physician and number of patients scheduled.
Copyright © 2010 US Oncology, Inc. All rights reserved.

5. 8 :0
0
1
2
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4
5
6
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8
9
0A
8 :1 M
5A
8 :3 M
0A
8 :4 M
LCL=2.4188
UCL=8.1329
CEN=5.2759
5A
9 :0 M
Copyright © 2010 US Oncology, Inc. All rights reserved.
0A
9 :1 M
5A
9 :3 M
0A
9 :4 M
5A
10 M
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10 AM
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10 AM
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11 AM
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Individuals Chart
12 PM
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12 PM
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P
1 :0 M
0P
1 :1 M
5P
1 :3 M
0P
1 :4 M
5P
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2 :1 M
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0P
2 :4 M
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3 :0 M
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3 :1 M
5P
3 :3 M
0P
3 :4 M
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Individual Moving Range Chart
0P
M

6. Current Data Analyses
 Average (Mean) patients per time slot is 5.27.
 Standard deviation is 2.4.
 Total number of patients for the day is 153.
 Total number of time slots is 224.
 Usage 68.3%.
 Mode 7.
 Median 6.
 Average wait time 31 minutes.
 Data needed:
 Wait time per lab process.
 Wait time per drawing blood.
 Wait time per patient/per physician.
 Wait time per patient load.
Copyright © 2010 US Oncology, Inc. All rights reserved.

7. Data Analyses
 Other tools which we need to use:
 Cause and Effect Diagram.
 Design of Experiment (DOE) to see what impacts the wait
time the most.
 Scatter Diagram to show relationship between wait time,
physician, patient load, and time of day.
 Hypothesis testing to prove or disprove any hypothesis.
Copyright © 2010 US Oncology, Inc. All rights reserved.

8. Improve
 Continue collecting data to see if patient wait time has improve.
 Example of how we might improve the patient wait time.
 Increase Average (Mean) patients per time slot is 5.27 to 6
 Hire 1-2 phlebotomists.
 Increase total number of patients 194 74% usage instead of
58.8% (48% increase)
 Reduce - Standard deviation from 2.4 to 1.
Copyright © 2010 US Oncology, Inc. All rights reserved.

9. Control
 Document new process and new procedures for reduced wait
time.
 Communicate this to customers as well as physicians and
workers.
 Communicate improve and savings to everyone.
 Share success.
Copyright © 2010 US Oncology, Inc. All rights reserved.

10. Process Map
Copyright © 2010 US Oncology, Inc. All rights reserved.

11. 8 :0
0
1
2
3
4
5
6
7
8
9
0A
8 :1 M
5A
8 :3 M
0A
8 :4 M
LCL=2.4188
UCL=8.1329
CEN=5.2759
5A
9 :0 M
Copyright © 2010 US Oncology, Inc. All rights reserved.
0A
9 :1 M
5A
9 :3 M
0A
9 :4 M
5A
10 M
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10 AM
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10 AM
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10 AM
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11 AM
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11 AM
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11 AM
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11 AM
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12 AM
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12 PM
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Individuals Chart
12 PM
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12 PM
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P
1 :0 M
0P
1 :1 M
5P
1 :3 M
0P
1 :4 M
5P
2 :0 M
Individual Moving Range
0P
2 :1 M
5P
2 :3 M
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2 :4 M
5P
3 :0 M
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3 :1 M
5P
3 :3 M
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3 :4 M
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M