Cleveland Clinic Regional Express Care Throughput Project

TEAM MEMBERS: AMANDA TAMERLANO XINZHUO CHEN

MENGHAO ZHANG WEI GUI

Company Introduction The Cleveland Clinic is a multispecialty academic

hospital located in Cleveland, Ohio that is owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921. In addition to their flagship hospital in Cleveland, Cleveland Clinic also operates affiliated facilities in Florida, Nevada, Canada, and the United Arab Emirates.

Nationally recognized as one of the top medical centers in the US and the world, particularly in technological and management systems and in the treatment of cardiovascular disease

For high acuity conditions requiring special expertise or the latest technology, it is ranked as the #2 hospital by U.S. News & World Report (USNWR).

Project IntroductionObjective: Decrease the total waiting time of patients.Main Problem: Unconstrained resources:

Eg: examination room in Cleveland Clinic Express Care Center, Strongsville

Unstable patients visiting rate:

this is uncontrollable factor, only can pay more attention during rush hour

Inappropriate resource allocation:

the number of examination rooms, MAs and PAs are not optimal so that there is always a Bottleneck

Project Process Map

Model: Wait Time Estimator Factors Considered: Number of rooms Time in Room # of people in waiting room # of PA # of MA Current Time Average MA Time Average PA Time

Simulation AssumptionsAssumptions Simulation 1 Simulation 2 Simulation 3 Simulation 4 Simulation 5 Simulation 6

Num. Rooms 2 3 4 5 5 5Num. Provider 2 2 2 2 2 3Num. Medical Assistants 3 3 3 3 4 3Mean Provider Time (Min) 10 10 10 10 10 10St. Dev. Provider Time (Min) 11 11 11 11 11 11Mean Medical Assistant Time (Min) 5 5 5 5 5 5St. Dev. Medical Assistant Time (Min) 2 2 2 2 2 2

Simulation Data

Simulation ResultsThrough hypothesis testing we

found that the average throughput time significantly decreased when we added there were 1 and 2 more rooms, but adding a third room did not significantly reduce the average throughput time the bottleneck had shifted.

Reasons for Decrease in Throughput Time

Wait Time Summarized

Increasing Other ResourcesSimulation 5: add MA Simulation 6: add PA Hypothesis testing shows

significant decrease in average throughput time when an additional PA is added and not when an additional MA is added.

Balance: 1 PA for every 2 Rooms, 1 more MA than number of rooms

Improve Round 1

Save time for new patients Multiple illness

Round 2 More machines Work standardization

Round 3 Automatic standardization Better allocation

Round 4 Add room and PA

Control Root cause analysis

Reason for long throughput time

Implement strict process revision Standardization of working process

Collect data and Measure Did volume level, increase or decrease due to wait time estimator? How is throughput impacted?

Future workMore data needed for illness type and corresponding throughput time

Relationship between throughput time and number of patients in room needs further research

Work with IT to pull data out of EPIC system, create model to surface expected time to see provider

Create APP for the sites selection

Key Recommendations Collect further data to find the impact certain conditions have on throughput time

Find ways to pull data out of EPIC system to surface estimated wait time to see provider This will also give competitive advantage because most competitors give wait time to be seen my

medical assistant.

Measure impact of volume on staffing and look to optimize resources 1 provider for every 2 rooms, 1 more medical assistant than number of rooms

Measure impact of surfacing wait time and hourly volume graph to see if it is achieving goal or failing