The Situation:

Tracy Gustafson earned her medical degree from the Northern Ontario School of Medicine located in

Sudbury, Ontario. She completed her residency at the Sudbury Regional Hospital and decided that she would

remain in Sudbury to begin her practice in the North as a General Surgeon.

Five years ago she opened a clinic with another surgeon, Matt Alexander, who she met at school. The

practice includes the $2$ surgeons, and $5$ support staff including $2$ nurses, $2$ receptionists, and you $-$ their office

manager.

Over the past $12$ months, Tracy and Matt have found themselves feeling overworked from working long hours

and they are wondering if they should add another doctor to the clinic. They have asked you to gather data

and analyze it in order to provide them with a recommendation.

From the research you have completed and the statistics you have collected you have found the following

information to help formulate your recommendation:

$.$ The 'overwork' seems to come from their surgical hours, over which they have little control. Because the

hospital does all the bookings they cannot add additional time to their allotted operation schedule.

$$ The Sudbury Regional Hospital Operating Department books operating room time for each surgeon $3$ days

each week, Tuesday $-$ Thursday from $7$:$30$ a$.$m$.-12$:$30$ p$.$m$.$

$$ Both surgeons end their surgical hours at noon each day to provide a lunch break and to allow for travel to

their office immediately following the surgeries so that they can begin seeing patients at $1$:$00$ p$.$m$.$ off site

at their clinic.

$.$ The surgeons do not work on the weekends and they reserve Mondays as 'patient$-$free' days to catch up

on office work and attend conferences.

$$ The surgeons insist on a $10\%$ safety capacity each week to allow for unexpected problems and emergency

referrals.

$.$ The following table shows the relationship between the surgical procedures and the related times for

changeover, activity time, demand, and assigned surgeon:

Assigned

Doctor

A

A

A

B

B

B

B

Procedure

lleostomy

Lobectomy

Septoplasty

Tonsillectomy

Appendectomy

Hysterectomy

Surgical Procedure List

Setup$/$Changeover Time

$[$minutes$]$

Cholecystectomy $54$

$60$

$60$

$52$

$44$

$26$

$31$

The hospital requires a minimum of $19$ minutes in the setup$/$changeover category to prepare the operating

room for the next surgery. Tracy and Matt have added time to the changeovers after each surgery in order to

allow them time to wash up$,$ rest an appropriate amount of time, and review the patient files in order to be

properly prepared for the next surgery. The surgeons have decided upon these times and are not very

interested in reducing them because they feel that reducing the changeover times would make them feel

rushed and it might lead to medical and surgical errors.

Procedure Time

$[$minutes$]$

$80$

$120$

$150$

$70$

$60$

$30$

$90$

Demand $[$# of patients

scheduled each week$]$

$1$

$4$

$2$

$2$

$3$

$2$

$3$

In a Excel spreadsheet, show your work and answer the following questions:

$1.$ What is the total minutes available per surgeon considering the safety capacity required? $[2$ marks$]$

$2.$ What is the current workload for the surgeons? Show your answer in total minutes per surgeon as well

as utilization rate per surgeon. $[5$ marks$]$

$3.$ Based on the current workload, should Tracy and Matt hire more doctors? If you determine the

utilization is to high suggest possible solutions. $[4$ marks$]$

$4.$ Prepare $2$ separate what if scenarios to show the effect on capacity of the following:

$1.$ What if changeover time is reduced by $50\%$ and the procedure time stays the same? $($keep in

mind the minimum allowable changeover time$)$ Show the affect on Changeover time as well as

utilization for each surgeon $[3$ marks$]$

$2.$ What if surgeries could be completed $20\%$ faster but with the original setup$/$changeover time?

Show the affect on procedure time as well as utilization for each surgeon $[2$ marks$]$

$5.$ What are your final recommendations to the business owners? $[$You must provide evidence$-$based

reasons for your recommendations$][4$ marks$]$

Please answer the following question to continue:

Based on the information provided above, what is the minimum minutes required by the hospital for

setup$/$changeover$?$