Case Study #1 Weight Solutions Clinic-Bariatric Surgery Center 1.

Flow map
40%

START

A. 1st Appointment 5 mins

B. Initial Consultation 20 mins

60%

C. Test Request 10mins

D. 2nd Appointment 5mins

E. Test 60mins

F. Test Available Within 2weeks

Insurance
Cash or

Disapproved 50%

Insurance

G. Letter preparation 20mins

H. Test Approval 3 weeks

Approved Or Disapproved

I. Request Additional Test 3 weeks

J. Setting Appointment 5mins

K. Visiting Surgeon 15mins

Cash O. Pre-surgery appointment 5mins 90%

Approved 50%

L. Additional Test 15mins

M. Add. Test Result available Within 2days 80%

N. Receiving Final Decision 2 weeks

10% P. Pre-surgery Visit 20mins Q. Surgery Scheduling 10mins R. Seminar 60mins S. Patients PREP and wheeled 30mins T. Surgery room disinfection 15mins U. Operating team PREP and cleaned 15mins Open Or
Laparoscopic

END Give up the surgery

60%

V. Open Surgery 45mins

W. Recovery and Check up 4days Z. Follow up 30mins

40%

X. Laparoscopic Surgery 75mins

Y. Recovery and Check up 2days

END

2. Minimum Time -Cash/ Open bariatric surgery: 6days, 250 minutes -Insurance/ Open bariatric surgery: 1) Quick approval: 3 weeks, 6days, 300 minutes 2) Late approval: 8 weeks, 8days, 350 minutes Avg. 5.5 weeks, 7days, 325 minutes -Cash/ Laparoscopic surgery: 4days 310 minutes -Insurance/ Laparoscopic surgery: 1) Quick approval: 3weeks, 4days 330 minutes 2) Late approval: 8weeks, 6days, 380 minutes Avg. 5.5 weeks, 5 days, 350 minutes

3. Open surgery/ Cash - How many patients/ week? For each beginning of the week 1) 24+24+15 = 63 patients/ week 2) Bottleneck resource? In-patient rooms Laparoscopic surgery/ Cash - How many patients/week? 1) For each day of the week 16 x 5 = 80 patients/ week 2) Bottleneck resource? Operation rooms 4. All patients: Cash/ Open surgery (100 waiting patients before Test, 200 waiting patients before Surgery) When can a patient who has finished the initial consultation and decided to continue expect to be scheduled for surgery? 2 possibilities 1) on 8th working days morning (7:40 a.m.) after initial consultation 2) on 8th working days morning (10:20 a.m.) after initial consultation 5. All patients: Open surgery/Insurance How many patients/week? Bottleneck is on in-patient rooms, therefore 63patients/ week 6. All patients: Open surgery/Insurance How much money/ week? With full capacity 63 patients x 15,000= $ 945,000/ week 7. All patients: Laparoscopic surgery/ Insurance Where should the Bariatric Center invest to improve capacity? Available time of surgeon (especially before surgery consultation, patients visit, letter preparations etc.) The choices- hiring another bariatric surgeon or two general practitioners Hiring 2 general practitioners is a better choice. Hiring another surgeon can also resolve the problem of insufficient available time of surgeon, however, hiring 2 general practitioners can also resolve the problem for a cheaper price. 8. From a financial perspective, is the Center better off encouraging more laparoscopic or open surgeries? For a financial matter, encouraging laparoscopic surgery is a better decision. The average expected price for the center when conducting an open surgery (divided into cash and insurance) is smaller than that of laparoscopic surgery. Therefore, it is profitable for the center to conduct more laparoscopic surgeries.