PAEDIATRIC ORTHOPAEDIC CLINIC Harvard Case Solution & Analysis



The Children’s Hospital of Western Ontario is Canadian based pediatric hospital that is located in the London, Ontario. The specialty of the hospital is in pediatric where the hospital provide qualitative services for their patients. However, the Children’s Hospital was the first facility in the world that installed a Cobalt-60 Beam Therapy to provide radiation therapy to patients who are infected by Cancer. Furthermore, the hospital fabricated their branches over 10 countries where the hospital catered the health of around 0.4 million of children on the hand more than 1.4 million of patients are treated by the hospital(Robert Klassen, 2008).

The timing of the clinic were 8:30 am to 1:00pm which operated their services trice in a week from Monday to Wednesday and served around 80 patients in each half day shift but the 60% out of 80 patients were returned patients due to their appointments with other doctors. Each shift of the clinic had have a surgeon, senior students (two resident students), three clerks and four registered nurses. The CHWO hospital provide services regarding pediatric treatments while having the clinic of pediatric ophthalmic and the clinic play a vital role in the treatment of severe bone injuries and the complex bone trauma.

Problem Statement

The Children’s Hospital of Western Ontario was a well reputed hospital and provided services for the treatment of severe bone injury and complex bone trauma, but the hospital was facing the long time waiting issues. However the management of the hospital decided to reduce the waiting time up to 20 percent which would increase the flow of patients and this would help the hospital to increase the rate treatment cases in each half day. So, that is why the management of the hospital decided to reduce the waiting time up to 20% in future.

Process Flow Diagram

Activity Utilization

The process of the calculation of activity utilization can be calculated by analyses the data that is obtained from the time information and the patient’s reviews that help in the calculation of the rate of activity utilization. For the calculation rate each division is needed to calculate separately with specific job title for each utilization rate. To calculate the rate of activity utilization individually the total number of hours which are spend on the process would be divided by the total number of hours that will be existing for each employee to perform their services.

The pediatric orthopedic clinic of CHWO has four main divisions which include the front desk, X-ray, Radiology, and examination. To calculate the activity utilization every activity that is taking place in each division will be analyzed. As in the front desk, there are two activities carried out however the first activity is registration where 3 clerks work for 180 minutes each hence the total available time is approximately 540 minutes. While five minutes is needed for each patient however the total number of patients that can be registered in the duration of the given session is 108 patients. The activity utilization rate of the 80 patients in each session is 74%. The second activity is handled by the three nurses who complete the verification process of the patient’s documents where the required time for each patient is 11 minutes while for follow-up the required timing is five minutes for each patient. The required time for each nurse is 155 minutes while the total time available for three nurses is around 765 minutes per session which is starting from 8:30 am to 12:45 pm.

The radiology department performed three activities in which there are six x-rays operating technicians working for the imaging. However, the total available timing is 960 minutes as the 2/3rd of radiology departments have timing that is available for the pediatric clinic. For imaging each new patient, the required time is around 11 minutes while for the follow-up it is around 9 minutes. The required timing for 32 new patients and 48 follow-up patients is around 784 minutes hence the utilization is calculated as 82% of the activity rate.

X-ray development is the second activity that required around 7 minutes because of the automation activity of the x-ray machine as well as the adjustment of the patient in accordance to the machine so the total time which is available in 960 minutes while form this time the only needed time is 560 that yield a utilization of 58%. After the imaging, the third activity is performed by the radiologist where they read the x-ray image for the reviewing of the image normally a radiologist takes 5 minutes for each patient. The available timing for the clinic’s patients is only 2/3rd of the radiologist with the x-ray equipment so the total available timing is 480 minutes (2/3*3*240)

From the above analysis of each given information of the clinic, the total available timing for the activity of direct labor is 4,270 minutes on the other hand the total timing that is available in 3,365 minutes so this indicates that the overall direct labor utilization rate was 75% (See Appendix 1 & 2)....

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