Service Journal: Question 9 of 15

1. Describe a major customer queue in your focal organization's service process.
As with all healthcare provider's there is usually a major queue that forms at the junction where appointments though scheduled for a particular time one does not see the physician till 30min to an 1hour after checking in at the front desk. Patients sign in at the front desk whereupon if it is their first visit they will spend 20 minutes filling out paperwork, if not then they will usually just show their insurance card an take a seat. Usually it takes 10 to 20 minutes before a nurse practicioner will initially see them and take a normal panal of tests (checking the patients temperature, blood pressure, and asking general questions. The patient will then wait another 10 to 20 min for the doctor to arive who usually repeats asking the same general questions. The doctor dependant on what ails the patient will then leave the patient for yet another 10 to 20 min before they come back to perscribe medicine, lab tests, and/or diagnose/prognose the patients disease. They then leave the room again to write up the perscriptions, lab tests required and doctors notes while the patient waits another 10 to 20 minutes. The doctor finally returns and dismisses the patient with perscriptions, lab tests, and/or a referal to see another doctor. Thus perpetuatuing the queuing at other areas with in the hospital system.


2. Explain how some of Maister’s principles (see below) might be applied to decrease the psychological costs of the queue without increasing server capacity. Alternatively, how could a pre-process wait be turned into an in-process wait by starting the production process with customers while they are waiting (be creative).

Maister's Psychological Principles of Waiting

· Unoccupied waits seem longer than occupied
· Pre-process waits seem longer than in-process
· Anxiety makes waits seem longer
· Uncertain waits seem longer than waits of known duration
· Unexplained waits seem longer than explained
· Unfair waits seem longer than equitable
· More value the service, the longer people will be willing to wait
· Waiting alone seems longer than waiting in a group

Many of the waiting at the begining of the visit could be decreased by having a nurse practicioner take the patients blood pressure and other diagnositics at the time of check-in. General questions could be answered by the patient with a checking sheet that would be attached to the outside of the patients file. These questions will help doctors reduce redundancy at a glance as questions will put in ailment buckets. For instance a patient complaining of gastric problems would answer questions that would be easily identified by the number of check marks on that area of the check sheet. Doctors would notify patients how long they intend to step away and what they will be doing so as to reduce ambiguity that work is being performed. Instead of leaving the patient the doctor could have a terminal where they could access patient records and write persciptions in the presence of the patient. This would reduce the number of trips out of the room and though the patient may still wait the same amount of time they would have the doctor performing his duties in the eye line of the patient thus increasing the level of doctor patient involvement. To reduce anxiety with waiting the doctor office and rooms should have assignments for the patients for times that patients will be left alone, thus distracting their train of thought and boredom.