Journal article
Choosing which practitioner sees the next patient in the preanesthesia evaluation clinic based on the relative speeds of the practitioner
Anesthesia and analgesia, Vol.116(4), pp.919-923
04/2013
DOI: 10.1213/ANE.0b013e31826cc0ba
PMID: 23354335
Abstract
When a practitioner in a preanesthesia evaluation clinic is not evaluating a patient because no patient is waiting to be seen, the practitioner often has other responsibilities such as reviewing charts of patients. When practitioners differ in how quickly they complete evaluations, multiple scenarios can be created wherein the slowest practitioner would only evaluate patients when the number of patients waiting exceeds a threshold (e.g., at least 2 patients are waiting). Review of operations research studies identified conditions for which such management of the queue can be beneficial (e.g., mean evaluation time of the fastest practitioner is less than half that of the slowest practitioner). These conditions were compared with the actual completion rates of certified registered nurse practitioners at a hospital's clinic. The 99.9% confidence intervals (CI) were calculated for ratios of mean evaluation times. The fastest practitioner was typically 1.23 times faster than the second fastest practitioner (CI 1.22-1.23) and 1.61 times faster than the slowest of three practitioners (1.59-1.61). These are significantly less than the 3 times and 2 times faster, respectively, that would be sufficiently large to warrant managing queue discipline. Practitioners with longer mean evaluation times had larger percentage utilizations of working time (Kendall τb = 0.56, P = 0.0001), inconsistent with preferential assignment of patients to the fastest practitioner(s) available. Practitioners' speeds in evaluating patients do not differ sufficiently for information systems to be used routinely to choose who evaluates the next patient (i.e., state-dependent assignment policy). Clinics aiming to reduce patient waiting should focus on reducing the overall mean evaluation time (e.g., by chart review ahead), appropriately scheduling patients, and having the right numbers of nursing assistants and practitioners.
Details
- Title: Subtitle
- Choosing which practitioner sees the next patient in the preanesthesia evaluation clinic based on the relative speeds of the practitioner
- Creators
- Franklin Dexter - Department of Anesthesia, Division of Management Consulting, University of Iowa, 200 Hawkins Dr., 6JCP, Iowa City, IA 52242, USA. Franklin-Dexter@UIowa.edHyun-Soo AhnRichard H Epstein
- Resource Type
- Journal article
- Publication Details
- Anesthesia and analgesia, Vol.116(4), pp.919-923
- Publisher
- United States
- DOI
- 10.1213/ANE.0b013e31826cc0ba
- PMID
- 23354335
- ISSN
- 0003-2999
- eISSN
- 1526-7598
- Language
- English
- Date published
- 04/2013
- Academic Unit
- Health Management and Policy; Anesthesia
- Record Identifier
- 9983806370802771
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