UNIVERSITY HEALTH SERVICES

Case Analysis










GROUP D

University Health Services (UHS)
Medical Care to Harvard University students, staff, faculty & their dependents
Prepaid system for over 90% of potential users
4 outpatient clinics including 1 walk in clinic
$ 10 mn total annual budget- 20% share of Walk In clinic
Walk In Clinic
37400 patients visited the Walk in clinic in 1979
Average of 143 patients per day
22 physicians, 2 registered nurses and 11 nurse practitioners
Pre Triage System

Triage System

Triage System Problems
Both system and waiting time for all types of patients increased
% of patients who wanted to be treated by a specific nurse or physician increased from 19% to
24%
To avoid load during peak hours, triage coordinators started classifying patients as MD/NP
increasing unnecessary load to MD
Walk In Appointments
Patients come for pre booked appointments to the Walk In Clinic
This results in 2 out of 5 doctors being engaged in walk in appointments
40% further reduction of available resources
Waiting rooms are occupied by such patients
Dissatisfaction of true walk in patients- they need to wait for longer times if they want specific
MD



Recommendations
Walk in commitments should be restricted to specific slot so that the capacity can utilized
properly
Triage nurses should not give the option of meeting specific doctors- Aim is to provide best
possible care to all the patients
Education of walk in patients is essential
Pre filling of request forms can be done on phone