1.) Use the information in Exhibit 3 (patients reported total times) and Exhibit 5 (theoretical time) to find wait time in each stage of the process. Find Process Flow Efficiency at each stage. Make sure to use the correct percentage of patients of each type at each stage.

Step	Total Time [min] [Exhibit 3]		Activity Time [min] [Exhibit 5]		Wait Time [min] [Total Activity]		Efficiency [%] [Activity / Total]
	New Patient	Follow-Up Patient	New Patient	Follow-Up Patient	New Patient	Follow-Up Patient	New Patient	Follow-Up Patient	Average
Front Desk	30	25	14	9	16	16	46.67	36	40.3
Radiology
Hand-Off
Examination Room

2.) Using the flow (throughput) into each activity (and buffer) and the times calculated above, you can apply Littles Law and find the average number of patients at each stage. How should the clinic use these numbers?

Step

Number of Patients [Process Flow Diagram]

Opera-ting Time [min]

Average Flow [Patients/Time] [R]

Activity Time [min] [Exhibit 5] [Tp]

Wait Time [min] [Total Activity] [Ti]

Average Work-In-Process Inventory [patients] I = RT

Average Buffer Inventory [Patents] [patients] I = RT

New Patient

Follow -Up Patient

New Patient

Follow -Up Patient

New Patient

Follow -Up Patient

New Patient

Follow -Up Patient

New Patient

Follow -Up Patient

Total

New Patient

Follow -Up Patient

Total

Front Desk

Registration

32

48

180

0.18

0.27

5

5

16

16

0.89

1.33

2.22

2.84

4.27

7.11

Verification

Radiology

Imaging

Developing

Diagnostics

Hand-Off

Collection

Exam Room

Preparation

Examination by Surgeon

Examination by Resident

Casting

Exhibit 3 PATIENTS' REPORTED TIMES SPENT IN THE CLINIC New Patients4 Follow-up Patients average (minutes) Steps average (minutes) standard deviation (minutes) 1. Front Desk 2. Radiology department' 3. Hand-off of X-ray to Clinic 4. Examination room 30 25 4 58 58 38 Notes: 1. Statistics are based on 218 patients over six Clinic sessions 2. Standard deviations were similar for new and follow-up patient times 3. All Steps reported by patients include wait and activity time 4. On average, 40% of total appointments are new patients. 5. All new patients and approximately 85% of follow up patients require an X-ray Source: Internal records