In 2018 the clinic carried out 5,639 procedures for which it received an average payment of $1,400. It operated 48 weeks, 5 days per week, being closed Sunday and Monday. A single technician came in on Sundays to perform post-operative check-up for procedures done on Saturday (the day before).

Staffing

The clinic is staffed with one receptionist, four patient service representatives (PSR), three technicians, two surgeons (a staff surgeon and Dr. Kendall) and one cleaner. The staff surgeon performs most surgeries. Dr. Kendall manages the clinic and only schedules surgeries 2 days per week, performing on average 8 surgeries per day. Non-surgeon staff work 48 weeks per year, 5 days per week, and 8-hours per day. Surgeon staff work 48 weeks per year, 5 days per week, and 7-hours per day.

The clinic currently has two Intake rooms, two Examining rooms, and two surgical rooms available.

Operations

Patients called the clinic referred by ophthalmologists and had an initial conversation with one of the PSRs. The number of calls received annually from patients that have interest in the procedure is 14,345. About 20% of the calls were screened out for not presenting evidence of cataracts; the other where scheduled an intake appointment. One week before the appointment PSRs mailed paperwork and called the patient with a reminder, most of the times they reached the voicemail. About 40% called back the PSR to reschedule.

From the scheduled appointments 75% show up. After check in with a receptionist, the PSR on intake spend on average 20 minutes with a patient, even though some took significantly longer. Intake included taking payment (returned in case of no-show) and collecting insurance information, and scheduling the surgery. PSR called with a reminder a few days before surgery, and again about 40% of patients called back to reschedule surgery. On surgery day patients check in with a receptionist.

About 70% of patients showed up for their surgery. A survey of no-shows revealed as main reasons for not showing up lack of funds/need for return of deposit, called to work, bad day for having surgery pain, problem getting a ride, afraid of eye operation. Quite a few people refused to explain.

The actual medical procedure began with one technician bringing the patient to the surgery room and prepping the patient for surgery. The surgeon would carry out the procedure, which on average took 15 minutes, then change, wash up, and record the surgery (an extra 5 minutes). They would then proceed to the next patient in another surgery room. In 2018 Dr. Kendall operated 768 times, with the remainder of surgeries completed by the current staff surgeon. After the surgery was performed the technician applied eye bandaging and then walked the patient back to the waiting area. Patients were asked to wait 30 minutes before they were checked out by a PSR. Between surgeries a cleaning employee took 3 minutes to prepare the surgical room for the next medical use.

The next day patients returned for a check-up with the technician, which takes about 10 minutes. Three weeks later the patients return for a second follow-up with the technician. About 21% of the patients do not return for the three-week check. Cleaning examination rooms between follow-ups with patients takes about 3 minutes.

Task	Minutes
Initial patient call	7
20% defect after this point
Mail paperwork	1
Call to remind	2
Reschedule call for 40%	2
25% defect after this point
Check-in at clinic for intake	2
Intake	20
74% Insured, 26% cash
Remind call	2
40% reschedule call	2
30% defect after this point
Check-in at clinic for surgery	2
Prep for surgery	10
Surgery, Cleanup, Record	20
Bandage, walk to waiting	5
Room cleaning	3
Check patient out	4
First (next-day) follow-up	10
Tuesday-Saturday room clean (80%)	3
Sunday room clean (20%)	3
3-week follow-up	10
21% defect after first follow-up
3-week room clean	3

Questions:

What is the current capacity, and capacity utilization of the following resources?

PSR
Technicians
Staff Surgeon