Process modeling: Create a process model based on the story collected by Mr. Carey and Ms. Reynolds. And answer the following questions:

a) According to the output reports, how many patients show up at the clinic in four weeks?

b) How many patients are taken care of by a doctor?

c) How many patients are sent to a hospital?

d) Which is the least utilized (human) resource and why?

e) Mr. Carey firmly believes that the phone calls to contact the relatives of patients, who are sent to a hospital, need to be made by the desk personnel (DP); yet, Ms. Reynolds thinks that it is Dr. Keller who has to make these phone calls. Provide a possible rationale supporting each opinion.

Process Description

Patients experiencing various health problems, or because they just need to have their annual checkup, head to ASK, at 115 Health Road, from 7:30 am to 4:30 pm weekdays (open hours) except on Fridays, when the clinic is open 7 am to 12 pm and Saturday morning when the clinic is open 9 am to 12 pm.

Carey and Reynolds report highlights that, at the check-in desk, about 20% of the patients need to come back because of various problems (they do not carry a valid ID, they do not have/remember their SSN, their insurance is not accepted by the facility, and so on). This initial screening takes 5 minutes and is performed by the desk personnel (DP). Seven people are employed as DPs and normally three are on duty, with two DPs being responsible for receiving patients (100% of their time).

The patients admitted about 4 per hour on average (as few as none and no more than 8) take a seat in the waiting room (right next to the check-in desk) where they wait to be called for vitals. Three nurses take vitals, which takes 6 minutes per patient. Each nurse has an equipped room assigned (exam rooms 1, 2, and 3).

Right after vitals are taken, patients are directed to the doctors. The patients whose vitals are fine (80%) go straight to Jessica (doctor room 1), who performs a general physical test and, if no issues emerge, completes the visit in about 20 minutes. Then, the patient is picked up by one of the three nurses and taken to the blood test lab where blood work is performed (5 minutes); after the blood test, the patient heads to the checkout, generally taking 3 minutes since all insurance information and copays are checked ahead of the admission. The checkout occurs at the front desk (and is performed by one of the DPs). The blood test lab is an open space with two stations where blood work can be performed (at the same time if two nurses are available).

Some patients readings show high blood pressure (16%) and are taken care of by Penelope (doctor room 2), because Penelopes specialization is cardiology. Penelope performs the testfff in 35 minutes, and then has the patient picked up by a nurse for the blood test. After the blood test,Penelopes patients also head to the checkout.

Unfortunately, some patients (4% on average) have vitals severely out of the ordinary: the nurses have a number of parameters that allow this type of evaluation, e.g. patients with a very high temperature (over 103F) in combination with high blood pressure reading of 200 or more (systolic) or 120 or more (diastolic). [No more details about these parameters are provided in this process description because they would go beyond the aim of this narrative and are not needed to appropriately analyze this process.] In these cases, patients are taken immediately to Robert, whose office is equipped for these types of quasi-emergency situations. Robert performs further medical tests (45 minutes), and then three types of patients are identified based on the test results.

Type-A patients: After Roberts careful evaluation (see above), he determines that the patient can be discharged (60% of the patients). In this case, the patient has a blood test (with the same procedure followed by Jessicas and Penelopes patients), and then checks out.

Type-B patients: For safety reasons, these patients needs to stay in the facility for three hours of observation (30% of the patients). This happens with patients who have a high temperature and symptoms of dehydration. These patients are sent to another area of the facility where there are six rooms dedicated for these quasi-emergency cases. In the observation room, the patient is monitored by an IT system for the whole stay (3 hours); if the conditions (according to the system reports) are better, the patient is sent for a blood test and then checks out (as per all other patients). A nurse, after three hours, checks the conditions of the patients from where she/he is (room 1, 2, or 3) and evaluates whether the patient can proceed to have the blood test (90% of the cases), or whether case 3 (see below) applies. It takes a nurse 1 minute to check the conditions of one of these Type-B patients.

Type-C patients: This patient needs to be sent to a hospital (10% of the patients). In this last case, either Robert or a nurse if a Type-B patient makes this decision. A phone call (2 minutes) is made by Dr. Keller, or by one of the DPs if Dr. Keller is busy, to inform the patients emergency contact about the hospital transfer.