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OM Chapter10 CaseStudy

By Stephanie & Sarita
by

Sarita Needham

on 15 November 2013

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Transcript of OM Chapter10 CaseStudy

Chapter 10: Orthopedic Surgeon Case Study
Overview
David Christopher:
Orthopedic Surgeon

Surgery clinic of him
& one other surgeon
12 support personnel

Surgeries 5 hours every morning, 4 days/week
7am-12pm Monday-Thursday

Clinic hours from 1pm-6pm
Monday-Thursday
Problem
Both surgeons working long hours
Do they need to hire more surgeons for the weekly workload they have?
Want 10% safety capacity
Current Workload
Available Working Hours per Surgeon per Week:
1 surgeon x 5 hrs/day x 4 days/week x 60 min/hr

= 1200 minutes/surgeon/week
x 2 surgeons = 2400 min/week of available surgery time
The 2415 scheduled mins is above the 2400 maximum capacity

10% safety capacity = 90% utilization rate
1200 minutes x 0.10 = 120 min of safety capacity per doctor
= 240 min total
Safety Capacity:
1200 minutes/surgeon/week – 120 minutes
= 1080 minutes per surgeon
2400 minutes – 240 minutes = 2160 minutes per week available total

Total Actual Available Hours with 10% Safety Capacity:
Determining Ideal Number of Surgeons:
2415 min/wk/surgeon / 1080 min/wk/surgeon
= 2.2361 surgeons
Demand = 2415
Available hours (with safety capacity) per surgeon = 1080

a. Hire one part time surgeon (only mornings four days a week)
3 surgeons x 1080 minutes/doctor/week = 3240 minutes

b. Hire one part time surgeon (2 mornings for a total of 10 extra hrs)
2.5 surgeons x 1080 minutes/doctor/week = 2700 minutes

(These are too high for our needed capacity)

c. Hire an extra surgeon only one day a week (total of 5 extra hrs)
2.25 surgeons x 1080 minutes/doctor/week = 2430 minutes

(This is closest to the 2415 scheduled minutes and thus would have the least idle paid time)
How many surgeons?
Other Alternatives to Optimize Throughput:
Current workload = 2415 minutes per week
No extra surgeons - use current two surgeons to capacity, but schedule
one less achillies tendon repair:

2415 minutes – 50 minutes (achillies tendon repair)
= 2,365 scheduled minutes


This results in approximate 1.5% safety capacity:

1 – 2365 min scheduled/2400 min available x 100% = 1.458%


Alternative A:
Alternative B:
Alternative C:
Alternative D:
Maintain a 10% safety capacity and 2 surgeons, but schedule less surgeries:

2415 minutes scheduled – 2160 minutes available = 255 minutes above capacity


If we take out a rotator cuff (90 minutes) and 2 ACL ligament repairs (80 minutes each) this adds up to 250 minutes, which is close to the 10% safety capacity that we want.

Safety capacity = 1 – 2165 minutes schedules/2400 minutes available x 100%
= 9.792%


Extend hours of surgery to 7am – 1pm with lunch from 1 – 2pm and maintain 10%
safety capacity:
2 surgeons x 6 hr/day x 4 days/wk x 60 min/hr = 2880 minutes per week
2880 x 0.10 = 288 minutes safety capacity
2880 – 288 = 2592 minutes available surgery time

This results in 177 more minutes than currently scheduled. Possible surgeries to schedule in this time:
• A knee surgery repair (180 minutes – would result in just under 10% safety capacity
• Two extra rotator cuff surgeries (180 minutes)
• 2 extra ACL ligament repairs (160 minutes)
• Highest in demand, and still more than 10% safety capacity

Alternative C fails to support post-surgery patient care normally from 12-2pm

Hire an additional doctor for the extra 2 hours each day to take care of the patients normally scheduled for the surgeons during those hours.
Recommendations
Lacking information:
on cost to hire extra doctor vs. hiring extra surgeon
on how excess revenue earned from the extra surgeries would off-set the cost of another doctor or surgeon.
We assume:
more cost effective to hire a doctor 8 hours/week compared to a surgeon for 5 hours/week
that this is in an ideal world

We recommend:
Questions or
Concerns
Alternative D
Full transcript