MAN6501: Operations Management 1 MAN6501: Operations Management Problem Set 1: Process Analysis and Improvement Instructions: 1. The case contains all of the necessary data to complete the assignment. If you believe critical data is missing, make an assumption. Any assumptions you make should be reasonable and consistent with other case data. 2. As a general rule, if you have a question about the “correct” interpretation of some aspect of the case or the assignment, you should just state your assumption and continue to work. In fact, these statements of logic will be used in the evaluation of your submission. MedNOW Clinic case The MedNOW clinic provides convenient healthcare services for a wide range of non-emergency medical issues. The clinic is located in Cambridge in close vicinity to a large hospital and serving a population with diverse ethnic backgrounds. Patients can walk-in or call in advance to schedule an appointment. The clinic operates 7AM to 7 PM on weekdays, with extended opening hours during the weekend. The clinic can do basic x-rays including chest x-ray and extremity x-rays (such as ankle, foot, arm and leg) and also provides lab services. On average 20 patients arrive at the clinic per hour, including walk-ins and appointments. Registration – The registration desk is continuously staffed with one person. They call the patient from the waiting room and create a patient record. The patient is then told to go back to the waiting room. The registration process takes on average one minute. Triage – The triage nurse calls the patients from the waiting room. They create a patient chart and register the check-in time. During triage the nurse determines the priority of patients' treatments based on the severity of their condition. The triage is staffed with one registered nurse (RN) and the average time for triage is about 2 minutes. On average, 10% of the patients require medical care that is not available at the clinic and need to be sent to a hospital in the vicinity of the clinic. The other patients are told to go back to the waiting room and wait for the doctor call. Examination – The clinic has four examination rooms and four MDs available at all time. An assistant calls the patients into the examination rooms and help the patient prepare for the examination. The examination time is highly dependent on the medical condition. Based on historical records the clinic has determined the following distribution for examination time: MAN6501: Operations Management 2 Probability 0.4 0.4 0.2 Time 2 minutes 8 minutes 10 minutes In 50% of cases the MD completes the diagnosis, writes a prescription and the patient is ready to discharge. The other 50% of patients require some form of diagnostic and are sent to the medical diagnostic lab. Medical Diagnostics – There are three areas of medical diagnostic testing each with its own staff. Analysis ...

1. MAN6501: Operations Management
1
MAN6501: Operations Management
Problem Set 1: Process Analysis and Improvement
Instructions:
1. The case contains all of the necessary data to complete the
assignment. If you
believe critical data is missing, make an assumption. Any
assumptions you make
should be reasonable and consistent with other case data.
2. As a general rule, if you have a question about the “correct”
interpretation of
some aspect of the case or the assignment, you should just state
your assumption
and continue to work. In fact, these statements of logic will be
used in the
evaluation of your submission.

2. MedNOW Clinic case
The MedNOW clinic provides convenient healthcare services
for a wide range of non-emergency
medical issues. The clinic is located in Cambridge in close
vicinity to a large hospital and serving
a population with diverse ethnic backgrounds. Patients can
walk-in or call in advance to schedule
an appointment. The clinic operates 7AM to 7 PM on weekdays,
with extended opening hours
during the weekend. The clinic can do basic x-rays including
chest x-ray and extremity x-rays
(such as ankle, foot, arm and leg) and also provides lab
services. On average 20 patients arrive at
the clinic per hour, including walk-ins and appointments.
Registration – The registration desk is continuously staffed with
one person. They call the
patient from the waiting room and create a patient record. The
patient is then told to go back to
the waiting room. The registration process takes on average one
minute.
Triage – The triage nurse calls the patients from the waiting
room. They create a patient chart
and register the check-in time. During triage the nurse
determines the priority of patients'

3. treatments based on the severity of their condition. The triage is
staffed with one registered nurse
(RN) and the average time for triage is about 2 minutes. On
average, 10% of the patients require
medical care that is not available at the clinic and need to be
sent to a hospital in the vicinity of
the clinic. The other patients are told to go back to the waiting
room and wait for the doctor call.
Examination – The clinic has four examination rooms and four
MDs available at all time. An
assistant calls the patients into the examination rooms and help
the patient prepare for the
examination. The examination time is highly dependent on the
medical condition. Based on
historical records the clinic has determined the following
distribution for examination time:
MAN6501: Operations Management
2
Probability 0.4 0.4 0.2

4. Time 2 minutes 8 minutes 10 minutes
In 50% of cases the MD completes the diagnosis, writes a
prescription and the patient is ready to
discharge. The other 50% of patients require some form of
diagnostic and are sent to the medical
diagnostic lab.
Medical Diagnostics – There are three areas of medical
diagnostic testing each with its own staff.
Analysis of historical records produced the following
information regarding demand for
diagnostics and test time:
Diagnostic 1 Diagnostic 2 Diagnostic 3
Test time 6 minutes 8 minutes 30 minutes
Proportion of test
requests
5 in 9 1 in 3 1 in 9
After the diagnostic test the patient is sent back to the waiting
room and waits the doctor call.
Re-examination – After diagnostics testing the MDs examine
the test results sent by medical

5. diagnostics. The analysis of the diagnostic results takes on
average 6 minutes per patient. Then
the MD calls the patient and spends on average an additional 6
minutes debriefing or prescribing
treatment. The patient is then sent to the discharge desk.
Discharge – The discharge desk is staffed with one person. They
copy key information from the
patient chart to the patient record system. On average it takes 2
minutes to complete the discharge
process for one patient.
Management is concerned with the ability of the clinic to meet
expected demand in an efficient
manner while providing adequate level of service. An internal
Kaizen team has been put together
to identify opportunities to improve patient flow at the clinic.
They provided management with a
report that lists the following possibilities:
1. Cross-train admin staff to work at both the registration and
discharge stations
2. Cross-train the RN to do admin work associated with
registration
3. Cross-train RN to handle some examinations and make
routing decisions

6. currently made my MDs.
4. Buy additional testing equipment
5. Hire additional MDs
The Kaizen team also collected data from patients to assess the
level of satisfaction with the clinic
services. The table below shows the primary areas of
dissatisfaction indicated by patients.
MAN6501: Operations Management
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Percentage very
satisfied
Percentage of respondents
rating dissatisfied or
unacceptable
Wait time for registration and
triage
15% 10%

7. Wait time for MD exam 5% 30%
Communication with MD 50% 10%
Greeting from receptionist 5% 30%
Queries about possible questions 5% 10%
Explanation about what to expect 2% 8%
Finally they have collected data concerning the patient waiting
time. The charts below show the
average waiting time (in minutes) for triage and for MD
examination (post-triage) during a one-
month period.
Mean = 9.9 minutes
Standard deviation = 4.806
Mean = 25 minutes
Standard deviation = 7.732
0.0
10.0
20.0

8. 30.0
1 3 5 7 9 11 13 15 17 19 21 23 25
27 29
Wait Timefor Triage
0.0
20.0
40.0
60.0
1 3 5 7 9 11 13 15 17 19 21 23 25
27 29
Wait Timefor MD exam
(posttriage)
MAN6501: Operations Management
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Questions:
MedNOW has hired you as a consultant to assist with the
analysis of the clinic’s service delivery
practices. They presented a set of specific questions below that
would like to see addressed.

9. 1. Draw the process flow diagram for the entire process at the
MedNow Clinic. Follow
formal notation to depict the workflow and show task times on
the diagram. (20 PTS)
2. How many patients can be processed at the clinic on a daily
basis? What is the
bottleneck of the process? Show your work. (20 PTS)
3. Consider the MD examination station. Why do customers
have to wait for an MD? Could
the process benefit from the implementation of a pull system?
Please explain and show
your work. (15 PTS)
4. Consider the five proposals for process change suggested by
the Kaizen team. How does
each proposal impact MedNow capacity? Explain briefly (30
PTS)
5. Which initiative would you recommend for implementation
(indicate only ONE)? What
type of data would you require for applying a PDCA cycle to
test and implement that
initiative? Be specific (15 PTS)