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This case is related to non-emergency patient caring in a Medical Center. At an average the center provides care to 63 patients per day. There

This case is related to non-emergency patient caring in a Medical Center. At an average the center provides care to 63 patients per day. There are 30 minutes non-paid break. The medical center works from 7:30 AM to 3:30 PM and its Patents Reporting Department receives Non-Emergency Patients. The reception/reporting department has three Receptionists for the registration of the Patients (walk-in or Pre-appointment). Each registration receptionist needs 15 minutes at an average for registering a patient. The work elements performed by the receptionists are following: Checking the previous record or existing record of a patient based on Picture ID and Insurance Card taken from the patient. If needed, updating the patients record related to address, contact telephone #, emergency contact #. Pre-appointed patients are allocated to the physicians mentioned in the appointment plan Walk-in patients are allocated to the Physician based on the choice of the Patients subject to availability of the Physician of choice, or available physician at the time of registering. Entering the health information related history of the walk-in patient based on the checklist filled-in by the patient. This step is not needed for pre-appointed patient or a patient who visited the center before. Taking payments for the medical center Printing the patient registration record including information on Physicians allocation (Patient Information package). Keeping the patient information package in a specified tray to be picked up by the Nurse of the allocated physician At the reception area of reporting department at an average five patients wait for their registration. Nurse picks up the registration record from the tray and calls the patient in Pre-diagnosis Nurse Check Room (PDNR). Nurse records weight, height, blood pressure, and temperature of the patient. In the next stage the Nurse asks the patients to describe the reasons for visiting the medical center. The nurse records the information in computerized software used by the medical center. The computer already has information on the Patient based on the information recorded by the receptionist. Information added by the nurse is the continuation of information on the patient to be looked at by the physician at the time of diagnosis/examination. Then the Nurse takes the Patient to the Doctors Chamber/Physicians room and the patient waits in the room for the physician. A Nurse takes 20 minutes to record this information and returns to her/his desk to work next patient or on follow-up of past visited patients based on Lab reports and Physicians advice. At an average seven patients wait in the reception area after registration to be called in by the Nurse. On typical day 4 physicians and 4 Nurses are there in the Non-emergency general care department The allocated physician comes to see the patient in the Doctors chamber/physicians room once the physician becomes free after checking, diagnosing and prescribing medicine to the previous patent in a different room. Average waiting time for a patient is 45 minutes in this stage. Average time taken by a physician for checking, taking history on the health condition of the patients, writing the diagnosis, prescribing medicine, advising lab works, or referring to other specialist: 60 minutes The patient picks up prescription, lab work advices, other advices, and leaves the Doctors chamber and goes to Lab or managed care. In this case we shall only consider Lab. At the Lab entry a Nurse takes the Physicians advice/prescriptions and registers the patient in the Lab. At an average waiting time for a patient to be called in sample collection room is 10 minutes In the next step a Lab Nurse calls in the patient and collects the samples based on Doctors Advice. A nurse takes 10 minutes to collect the samples The Patients exits once samples are collected. Lab analyses the samples and sends reports to Doctors office after 6 hours time (3 hours waiting in queue and 3 hours Lab work and report preparation. This time is average. Some report may take 1 day for some special test.) The Physician checks the lab findings and advices Patients in the computerized system, the nurse informs the patients on the change in prescription (that was given to the patent by the physician just after diagnosis) or additional advice based on Doctors advice by e-mail or by calling over telephone. Note: Make reasonable assumptions based on your visit of such medical center if you need further information/data during your Value Stream Map preparation

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