2.  Capacity Management seeks to improve organizational effectiveness by increasing operational efficiency and reducing patient congestion.  To include demand-smoothing and supply-matching strategies that will provide structure for a manager’s approach to effective ambulatory care.  To decrease the clinical resource base by proposing low cost strategies

3.  is the process of planning, sizing, and controlling service solution capacity to satisfy user demand at a reasonable cost.  or an essential element of efficient ambulatory care delivery.

4. Managing the capacity of an outpatient clinic requires a balanced consideration of both the demand for and supply of patient services. Actions that affect Service Capacity:  Long waiting time  Bottleneck Activities

5. Two Perspectives: 1) Smoothing Patient Demand- permits greater use of a relatively fixed or constant service capacity. 2) Managerial Control- matches the supply of services to existing patterns of demand.

7. Smoothing the demand for services involves: - Requirements for both scheduled and nonscheduled appointments - Regulating arrival of known patients through an appointment system/ making it more uniform. - Forecasting unscheduled Demands - Adjusting appt by time of day and day of the week. - Differential pricing- pricing incentives that reduce charges for services rendered. - Promoting complimentary services- (ex) health education, disease screening, or wellness promotions

8.  Effective Staff Scheduling  Cross-training clinical staff  Adjustable capacity and Sharing capacity  Increased participation on the healthcare consumer’s part. These strategies will increase the productive use of clinical capacity.

9. The University of New Mexico Cancer Center recently undertook a study of its medical oncology clinic. Staff concerns about congestion in the patient care delivery process prompted that more clinical examination rooms were needed. Two objectives: 1) Determining the characteristics of patient flow, including the ID of the major factors responsible for clinic congestion 2) Determining the present use of the examination rooms.

11.  Total of 108 Patients was included in the sample  Daily clinic visit rates ranged from 17 to 25 patients  Only 12% of the sample patients were making their initial visit while 88% were receiving follow up care.  Anything under 50% on the Mean Service Efficiency Percentage was given initial attention.  The average patient visited the clinic for a total of 96.3 minutes. Direct contact with doctor lasted (44.5) min. The remaining time was waiting time.  The nursing and medical services were designated as bottleneck activities since 70% of all patients required both services.

12.  Over all use of examination rooms averaged only 31%. This was found by dividing the total occupied time by total time available during the clinic’s hours of operation.

13. Analysis of Demand Factors  un-cancelled appointments affects congestion (Solution) encourage on time arrivals  facilities, equipment, and support personnel are periodically nonproductive when physicians are unavailable throughout the week. (Solution) Activities on those days like cancer screening and education activities that will expand nursing activities.  congestion affects service quality. (Solution) assign those with non important visits like drawing blood to come in on Friday’s to relieve congestion during the week for those with more serious problems.

14. Analysis of Supply Factors  available patient service resources do not appear to impede performance. (Solution) Consider use of examination room space for additional revenue.  Timely supply is critical (Solution) Increase patient participation in the service delivery process. Ex- filling out forms at home.

15. Effective capacity management can yield improvements in service levels from both patient and clinic perspectives. Managers should perform Patient-flow data collection activities whenever capacity inefficiencies are not readily identifiable. Using simple observation and data collection can provide useful information for capacity management. The strategies mentioned in this article will help the clinic stop spending on additional resources by being efficient with demand and supply.

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