Memo of Transmittal

To: Alexandra Kohler, M.S.

From: Natalie Weisenburger
Date: 27 November 2016
Subject: Proposal to Improve the Efficiency and Decrease Wait
Times at the Cal Poly Health Center
Attached is the recommendation report regarding Cal Polys Health
Center. The purpose of this report is to improve the efficiency and
decrease the wait times at the Cal Poly Health Center.
Recommendations
Two possible solutions to the ongoing problem are analyzed throughout
the report. The solutions are:
Increase the number of doctors and/or nurses that can be specific to
certain health conditions or illnesses
Implement a new electronic system that allows students to check in
online as opposed to going to the health center, which allows
students to monitor their place in line away from the confines of the
health center
Methods
In order to make the best recommendation possible, I utilized a variety
of research methods. My primary sources are:
Interview with Alexandra Kohler, M.S.
Online Survey of Cal Polys students
I referenced the following secondary sources:
Mustang News Article
Journal Article
Texas Tribune Article
Findings
The information discovered through my research in the methods
section is presented in the results section. Then, this information is
thoroughly analyzed in the conclusions sections
Final Recommendation
My chosen solution is the implementation of new technology that
allows students to check in online and wait in line anywhere they
choose.

Prepared for Alexandra Kohler, M.S.

Campus Health & Wellbeing

Proposal to Improve the Efficiency and

Decrease the Wait Times at the Cal Poly Health
Center

Prepared by Natalie Weisenburger

Submitted November 27, 2016

Table of Contents
Introduction
1-2
Purpose

. 1
Background

. 1
Organization

.. 2
Methods
. 2-3
Primary
Methods

.... 2
Interview

. 2
Online
Survey

... 2-3
Secondary
Methods
2-3
Newspaper
Article.....

2
Journal
Article

.. 3
Newspaper
Article.....

3
Results
3-4

Primary
Methods

.... 3
Interview

. 3-4
Online
Survey

4
Secondary
Methods...

. 4
Newspaper
Article.....

4
Journal
Article.

.. 4
Newspaper
Article.....

4
Conclusions
. 5-6
First
Solution

........ 5
Second
Solution

5-6
Recommendations
.. 6
References
6
Figures
Referenced
6

Table of Figures
Figure 1: Cal Poly students Health Center Survey
Response.... 1
Figure 2: Cal Poly students late or missed class
Survey Response... 5

Introduction
Purpose
The purpose of this recommendation report is to analyze the problem
where Cal Poly students struggle to be seen at the Cal Poly Health
Center in a timely matter and find the best-fit solution for the on-going
issue. The Cal Poly Health Center could be a great resource for all
students, whether they live on campus or not. However, the wait times
have become a serious deterrent for students seeking medical help.
According to a survey that I conducted and as seen in Figure 1, around
80% of Cal Poly students choose not to go to the health center because
it is inconvenient and they know it will take a long amount of time out
of their day [1]. With admissions of undergraduate students steadily
increasing each year it is apparent that this problem needs a solution
to better assist the students at the Cal Poly campus. My client is
Alexandra Kohler, M.S., the Assistant Director for Campus Health &
Wellbeing.

Percentage of Students that have chosen not to go to the Health Center due to long wait times.

no; 20%

yes; 80%

Figure 1: Cal Poly students Health Center Survey Response [1]

Background
The Health Center has very accommodating hours, Monday through
Friday from 8 a.m. to 4:30 p.m. except on Wednesdays when the
Health Center is open from 9 a.m. to 4:30 p.m. [2]. However, when
over 60% of students are walk-ins, it becomes very difficult to predict
how long it will take to be seen [3]. The current method that the health
center uses is to highly recommend students to create an
appointment. However, many students choose to walk-in, which makes
sense because it is difficult to predict when you are going to be sick.
This causes the possibility of walk-ins running into scheduled
appointments times, which creates delays and a lot of unpredictability.
This is an unfortunate situation because the Health Center has very

knowledgeable doctors, the people that work there are willing to help
you, and a lot of the prices that they charge are cheap compared to
those at other pharmacies.

Organization
The Introduction includes the purpose, background, and finally the
organization of the report to better understand how the report is laid
out. After the introduction section is the Methods section, which
explains the different sources that I used to obtain information for my
report. The methods include primary, such as interviews and surveys,
and a variety of articles for my secondary sources. My findings and
important information relating the sources to my report are located in
the Results section. I compare the two possible solutions to improve
the efficiency and decrease the wait times at the Cal Poly Health
Center in both the Results and finally in the Conclusions section. The
two solutions are listed below:
Increase the number of doctors and/or nurses that can be specific to
certain health conditions or illnesses
Implement a new electronic system that allows students to check in
online as opposed to going to the health center, and this creates the
ability for students to watch their place in line away from the
confines of the health center

Methods
To better understand the impacts of the Health Center wait times, I did
a substantial amount of research by various methods to collect a
variety of valid data. As my primary methods of research, I conducted
an interview and created an online survey. To supplement, I used
additional secondary sources such as journal and newspaper articles.
Primary Methods
Interview
I emailed the Cal Poly Health Center to request an interview from a
knowledgeable representative and received a reply from Alexandra
Kohler, M.S., Assistant Director, Campus Health & Wellbeing. She was
available for an interview via email. Therefore, I sent her a list of
questions. I received a reply from her on Tuesday, November 15, 2016.
My questions to her are as follows:
1. How many students visit the health center weekly?
2. How many of those students are walk-ins?

3. Has it occurred where a student has checked in but then not

been there when their name is called? If so, do you have any
data regarding that?
4. Is the Cal Poly Health Center doing anything to work on
shortening the wait times?
5. Is there any other information regarding the wait times or
students not staying because they have run out of time?
Online Survey
In order to receive as many student responses as possible, my online
survey was relatively short. The questions that I asked however did
help me reinforce the fact that this is a problem on our campus. 47 Cal
Poly students responded to the following survey, where I posed the
following questions:
1. What is the longest amount of time that you have had to a wait
to be seen by someone at the health center?
2. Have you ever walked out of the health center because there
was a long wait time?
3. Have you ever decided not to go to the health center because
you knew it would take a long time?
4. Have you ever been late or missed class because you set aside a
certain amount of time for the health center but it was not
enough time?
Secondary Methods
Newspaper Article
I found pertinent information from the Mustang News article, The
Health Center Basics from 2005 that I will use in my report.
Journal Article
I will take information from the journal article, Using Queuing Theory
and Simulation Model to Optimize Hospital Pharmacy Performance,
from 2014 to help substantiate my first solution.
Newspaper Article
The article, DPS Centers aim to Keep Customer Traffic Flowing, from
The Texas Tribune, published in 2013 contains information regarding
my second solution.

Results
My primary and secondary resources gave relevant information
regarding the long wait times and decreased efficiency at the Cal Poly
Health Center and plausible ways to fix this problem.
Primary Methods
3

Interview
I asked Alexandra Kohler the following questions and received the
respective answers [3]:
1. How many students visit the health center weekly?
Between 800-1,000 students.
2. How many of those students are walk-ins?
About 60% of those students are walk-ins.
3. Has it occurred where a student has checked in but then not been
there when their name is called? If so, do you have any data
regarding that?
Yes, that happens frequently.
4. Is the Cal Poly Health Center doing anything to work on shortening
the wait times?
We have hired two additional nurses to shorten the time between
checking in and being assessed. The only other option to
decrease wait times is to hire additional medical providers, which
we do not have the funding for.
5. Is there any other information regarding the wait times or students
not staying because they have run out of time?
We do encourage students during SLO Days and WOW to visit the
Health Center during our slower times between 8 10 a.m. We
also offer a variety of self-help resources on our website.
Online Survey
Of the 47 Cal Poly students that responded to my survey, 30 stated
that they have had to wait 1 hour or more and 20 stated that they
have had to wait 1 hour or less, during their duration at the health
center. 20 out of 47 students have walked out of the health center
because there was a long wait time. 37 out of 47 have chosen not to
go to the health center because they knew it would take a long time.
Finally, 25 out of 47 have been late or missed class because their time
at the health center took longer than they anticipated [1].
Secondary Methods
Newspaper Article
This newspaper article addresses the issue that there is certain times
of the year where the Health Center is very busy. They recognize that
especially during midterm season, when students are sleeping less, not
eating as well, and are under high stress, that the probability of
students getting sick is much higher. In general, the health center does
a great job of helping students on the Cal Poly campus. In this article
the health and wellbeing team highly recommends that students make
appointments because the wait time range can be unpredictable [2].

Journal Article
This journal article addresses my first solution of increasing the
number of personnel at the Health Center. Through tedious
experimentation and analysis the conductors of the study demonstrate
that the increase of physicians and health care professionals decreased
the wait time for patients. In this article they advise utilizing
multitasking persons and then placing them where they are needed
most at the time [4].
Newspaper Article
This newspaper article addresses one of my potential solutions of
making the process of waiting in line more online. Texas DPS centers
have decided to make technology a more integral part of the process
in order to drastically reduce wait time. The time that it takes to renew
a drivers license has been cut down to approximately ten minutes. The
technology allows citizens to get in line online; therefore allowing them
to do so not at a center but where ever is convenient. If a certain
citizen is running late, they can simply push themselves back in line
without having to get in the back of the line. Over the last 3 years, this
new innovation has been successful [5].

Conclusions
During midterm and final season, when numerous students end up
getting sick, the Cal Poly Health Centers long wait times forces those
students to choose between studying and their health and wellbeing.
As seen in Figure 2, almost 50% of Cal Poly students have had to be
late or miss class because the amount of time they allotted for the
health center was not enough. Healthier students do better in class
and cultivate a better learning environment. Therefore, the fact that
these students have to make this choice between their health and their
academics should compel the Cal Poly health center to resolve this
problem and decide between the two solutions that I am comparing.

Students that have been late or missed class due to the Health Center

yes; 47%

no; 53%

Figure 2: Cal Poly students late or missed class survey response [1]

My first solution is to increase the number of personnel present at the

Cal Poly Health Center so that the entire process takes less time. This
solution is advantageous because this would greatly reduce the
amount of time required to wait in the Cal Poly Health Center check-in
lobby. According to a queue study done in a military hospital in Iran,
increasing the number of physicians from 10 to 14 decreased the wait
time from 3.73 to .112 minutes [4]. This drastic change could be
seriously beneficial to the Health Center at Cal Poly. Additionally, this
solution would increase the overall knowledge at the health center
allowing for more, well rounded health care. Some disadvantages to
this solution are that this is very expensive; each additional physician
requires a salary and benefits, which at the moment, Cal Poly has not
allocated funds towards this department, and thus cannot afford [3].
Another disadvantage is that it will be difficult to tell how many
additional doctors are needed to truly make a difference on the
average wait time.
My second solution is to implement an electronic system that allows
Cal Poly students to check in online and wait in line wherever they
choose. Some advantages to this solution are that this would allow
students to continue studying while waiting in line to see a health
professional. A lot of students choose not to go to the health center
because they know it will take a long time to be seen [1]. However,
with this solution, students are no longer forced to spend thirty
minutes to three hours [1] at the Health Center check-in lobby, but
rather they can stay wherever they are and arrive ten minutes before a
doctor is ready to see them. According to the newspaper article from
the Texas Tribune, DPS centers utilize this electronic system and
alerts are sent out via text message letting customers know when
they should arrive at the center [5]. A disadvantage to this solution is
that the coding for the technology and gaining approval for the system
once created could take some time. Additionally, another disadvantage
is that this solution will not truly change the total wait time, just the
time that you wait at the health center.

Recommendations
Based on thorough research and examination, I recommend that the
Cal Poly Health Center implement new technology to allow Cal Poly
students to check-in online and wait in line at a place of their
convenience. The next step to this process is to find computer science
engineers to assist with the coding of this technology.

References

[1]N. Weisenburger, Cal Poly Health Center Wait Times, Survey. 13

November
2016
[2]K. Velie, "The Health center basics", Mustang News, p. 1, 2005.
[3]A. Kohler, "Ways to improve the efficiency and decrease the wait
times at the Cal
Poly health center", Interview. 2016.
[4]M. Bahadori, S. Mohammadnejhad, R. Ravangard and E.
Teymourzadeh, "Using
Queuing Theory and Simulation Model to Optimize Hospital
Pharmacy Performance", Iranian Red Crescent Medical Journal,
vol. 16, no. 3, 2014.
[5]C. Permenter, "DPS Centers Aim to Keep Customer Traffic
Flowing", The Texas
Tribune, p. 1, 2013.

Figures Referenced
[1] Figure 1. Cal Poly students Health Center Survey Response,.
Survey. 13
November 2016
[1] Figure 2. Cal Poly students late or missed class Survey Response,.
Survey. 13
November 2016