Essay About Main Patients And Triage System

Hospital Clinic Case
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After reading this article, what I recommend that the clinic do to make improvements to
their services there would be to:
1) Not have walk in appointment for their main patients.
2) Create a different strategy for the ambulatory visit.
3) Scheduling changes.
4) Expanding the nurse practitioner guidelines.
My first reason for not doing a walk in clinic for their main patients is because for being a
university and “walk in clinic” it defeats the purpose and the patients who come in who need
help can’t get because the doctors and nurses are already booked with other members. “It seems
that the doctors were allowed “walk in” appointments with their own regular patients. Patients
whose doctors have heavily booked appointment schedules become aware of the doctors walking
schedule and come to the clinic at prearranged times to meet. Our aim isn’t to provide an
atmosphere reminiscent of the country doctor’s office, but rather to provide the best possible care
to all our patients” (page 5 of article). According to the article patients were dissatisfied with
this service. The major complaint was the waiting time between the initial sign in time and the
period where the patient is seen by a doctor. ”A 1978 study of the clinic found that patients who
requested specific doctors at the initial sign in time waited an average time of 23 minutes, more
than 35 minutes for a patient nurse contact and 40 minutes before seeing a desired doctor. When
it came to 1979 the triage system was introduced at the clinic to reduce or to overcome these
problems and the patient who wanted to see a doctor right away increased. After the triage
system was introduced the rate increased up to 24% and it also why the wait time to see a doctor
increased. “If longer treatment by the doctor was anticipated, the patient joined the MD waiting
line, according to his or her AVF #. Thus, any patient in the waiting status quo who had arrived
before the referred patient would still be seen first. The mean times to see a doctor was much
longer (25.2 minutes)” (page 4 of article). According to exhibit 5 (shown in the appendix)
compares pre triage and triage wait times. They both have similar numbers but the pre-triage
wait time was shorter. Going back to recommending the clinic not be walk in would be
beneficial for the clinic but also the patients. I say this because this would help create a better
policy to establish a system where they don’t accept requests from the doctors. With a new
strategy in place, the patients who needs help right away from the doctor can call and make an
appointment to see the specific doctor or use the walk in service for the triage so that the patient
can be accessed.
The next recommendation that I would make for the clinic is to create a different strategy
for the ambulatory visit. I say this because, this form would go along with a new strategy for the
triage system. ‘There are a number of potential alternatives for dealing with this problem. We
could try and educate our patient public on the separate purposes and missions of doctor
appointments and the walk in clinic- try to get them to use each accordingally. They could also
ask the triage coordinators to be a little more aggressive in asking patients who request a specific
doctor” (page 6 of article). By having a new form into place, the triage nurses won’t have to deal
with evaluating and examining how bad the patient’s state is before sending them to a nurse and
the desired medical staff. By doing it this way, it has an advantage for the triage nurses and for
the patient. For the nurses it helps them to figure out if they really need to see a doctor. For the
patient it helps reduce the medical expense that they have to pay if they were to be seen by a
regular doctor. With the AVF forming changing the nurses will be able to help the patients more.
Also, the patients would not feel like they were being bounced from nurse to nurse only to be
asked the same questions over and over again. Fewer patients would be referred to a
doctor for cases that could be handled by a nurse practitioner. Doctors would be free to focus on
patients that do require a higher level of expertise to treat.
Another recommendation for the clinic would be for scheduling. I say this because the
doctors and nurses didn’t schedule anyone based on the quality of the patient demand. When
this happened there were times when the clinic was under staffed. “The walk in clinic was
staffed on the basis of past experience with peak periods of patient visits, which typically
occurred between 10 am and 4 pm. According to exhibit 4 (shown in the appendix) between the
hours of 8 am and 6 pm there weren’t very many doctors or nurses on staff to accompany the
patients when needed.
In addition as to why I think the clinic should change things with their scheduling is
because