Complete David Christopher Case Study

Complete David Christopher Case Studydavid Christopher Received His Me

Complete David Christopher case study David Christopher received his medical degrees from the University of Kentucky and the University of Virginia. He did his residency and early surgeries at Duke University Medical Center. Eight years ago he set up his own orthopedic surgery clinic in Atlanta, Georgia. Today, one other doctor has joined his clinic in addition to 12 support personnel such as X-ray technicians, nurses, accounting, and office support. The medical practice specializes in all orthopedic surgery, except it does not perform spinal surgery.

The clinic has grown to the point where both orthopedic surgeons are working long hours, and Dr. Christopher is wondering whether he needs to hire more surgeons. An orthopedic surgeon is trained in the preservation, investigation, and restoration of the form and function of the extremities, spine, and associated structures by medical, surgical, and physical means. He or she is involved with the care of patients whose musculoskeletal problems include congenital deformities; trauma; infections; tumors; metabolic disturbances of the musculoskeletal system; deformities; injuries; and degenerative diseases of the spine, hands, feet, knee, hip, shoulder, and elbows in children and adults. An orthopedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Osteoporosis, for example, results in fractures, especially in the hips, wrists, and spine. Treatments have been very successful in getting the fractures to heal. Dr. Christopher collected the data in Exhibit 10.9 as an example of the clinic’s typical workweek. Both surgeons work 11 hours each day, with 1 hour off for lunch, or 10 effective hours.

All surgeries are performed from 7:00 a.m. to 12:00 noon, 4 days a week. After lunch, the surgeons see patients in the hospital and at the clinic from 1:00 p.m. to 6:00 p.m. Over the weekend and on Fridays, the surgeons rest, attend conferences and professional meetings, and sometimes do guest lectures at a nearby medical school. The doctors want to leave a safety capacity each week of 10 percent for unexpected problems with scheduled surgeries and emergency patient arrivals. The setup and changeover times in Exhibit 10.8 reflect time allowed between each surgery for the surgeons to clean themselves up, rest, review the next patient’s medical record for any last-minute issues, and prepare for the next surgery.

Dr. Christopher feels these changeover times help ensure the quality of their surgery by giving them time between operations. For example, standing on a concrete floor and bending over a patient in a state of concentration places great stress on the surgeon’s legs and back. Dr. Christopher likes to sit down for a while between surgeries to relax.

Some surgeons go quickly from one patient to the next; however, Dr. Christopher thinks this practice of rushing could lead to medical and surgical errors. Dr. Christopher wants answers to the following questions. Case Questions for Discussion:

• 1. What is the clinic’s current weekly workload?
• 2. Should the clinic hire more surgeons, and if so, how many?
• 3. What other options and changes could be made to maximize patient throughput and surgeries, and therefore revenue, yet not compromise the quality of medical care?
• 4. What are your final recommendations? Explain your reasoning.

Paper For Above instruction

The case study of Dr. David Christopher's orthopedic surgery clinic offers a comprehensive look into the operational dynamics of a specialized medical practice experiencing growth and contemplating expansion. Analyzing the clinic's current workload, capacity, and potential for maximizing efficiency while maintaining quality care is essential for strategic planning and sustainable development.

Current Weekly Workload

To determine the clinic's current weekly workload, we need to assess the available surgical and clinical hours. Both surgeons work 11 hours daily, with a 1-hour lunch break, resulting in 10 effective working hours per day. Operating from 7:00 a.m. to 12:00 noon, four days a week, yields 4 days x 10 hours = 40 hours dedicated to surgeries per week. The surgeons also spend time post-lunch seeing patients from 1:00 p.m. to 6:00 p.m., adding an additional five hours daily for consultations and follow-up care, totaling 4 days x 5 hours = 20 hours weekly per surgeon.

Including weekends and professional meetings, the total weekly scheduled hours per surgeon amount to 40 hours for surgeries plus 20 hours for consultations, totaling 60 hours. Since there are two surgeons, the combined weekly surgical hours are 80 hours. To estimate the number of surgeries, we need to analyze the average duration of each surgery, considering setup and changeover times, which are crucial in estimating capacity accurately.

Estimating Surgical Capacity

The surgical periods are scheduled from 7:00 a.m. to 12:00 noon, 4 days a week. Each surgery includes specific setup, execution, and changeover times. According to typical standards in orthopedic surgery, individual surgeries may range from approximately 1 to 3 hours, depending on complexity. Setup and changeover times, which are critical for maintaining quality and safety, add to this duration. For this analysis, assume an average surgery time of 1.5 hours, including setup and changeover. Under this assumption, the maximum number of surgeries per morning session is 4 (7:00 a.m. to 12:00 noon), with each surgery lasting approximately 1 hour and the remainder allocated for changeover and preparation.

Including a 15-minute buffer for changeover between surgeries, the surgeons could perform up to 4 surgeries per morning session. Over 4 days, this amounts to up to 16 surgeries weekly, aligning with the current schedule. However, Dr. Christopher emphasizes the importance of safety capacity, maintaining a 10% buffer for emergencies and unforeseen delays, thus slightly reducing the maximum feasible number of surgeries to approximately 14 or 15 per week.

Should the Clinic Hire More Surgeons?

Given the data, if each surgeon can perform approximately 14 to 15 surgeries weekly, the current workload appears to be near capacity, especially considering safety buffers and quality practices. The combined weekly workload is about 30 surgeries, which suggests that the two surgeons are operating close to their maximum capacity, including allowances. Therefore, if the clinic aims to increase surgical volume significantly beyond this level, hiring additional surgeons would be advisable.

Specifically, introducing one more surgeon could increase capacity by approximately 14 to 15 surgeries per week, elevating the total to about 45 surgeries weekly. This increment would accommodate growth, reduce surgeon fatigue, and improve overall patient throughput. Moreover, an additional surgeon could help prevent burnout, improve service quality, and allow more flexible scheduling, including accommodating emergency cases more effectively.

Options to Maximize Patient Throughput Without Compromising Quality

Beyond hiring additional surgeons, the clinic can explore several options and operational adjustments to optimize throughput:

• Streamlining Setup and Changeover Processes: Implementing standardized procedures and reducing unnecessary delays can save time between surgeries. Automating or pre-preparing certain surgical instruments and supplies can also aid efficiency.
• Extending Clinic Hours: Introducing evening or weekend surgical sessions could increase capacity without overburdening current surgeons during regular hours.
• Optimizing Scheduling: Using advanced scheduling software can minimize gaps between surgeries, better allocate surgeon time, and adapt dynamically to delays or emergencies.
• Enhancing Surgical Team Efficiency: Cross-training staff and delegating post-operative tasks can speed up turnover times and improve overall workflow.
• Investing in Surgical Technology: Utilizing minimally invasive techniques or newer surgical equipment can reduce procedure times while maintaining or improving outcomes.

All these options emphasize maximizing existing resources and improving operational efficiency; however, quality and safety considerations must remain central to any changes.

Final Recommendations

Based on the analysis, the current workload of Dr. Christopher's clinic indicates near-maximum capacity within existing operational standards when safety buffers and quality practices are considered. To manage increasing patient demand, hiring at least one additional surgeon appears necessary. This addition would significantly enhance capacity, reduce surgical backlog, and improve the working conditions for the surgeons.

Furthermore, operational improvements such as streamlining setup procedures, optimizing scheduling, and investing in efficient surgical technologies should be implemented concurrently. These measures can further increase throughput without compromising patient care quality. While expanding hours or adding more surgical days could be considered, they may introduce risks related to staff fatigue and diminished quality. Therefore, incremental expansion through additional staffing, coupled with efficiency measures, is recommended as the most balanced approach.

In conclusion, hiring one more surgeon is a strategic move that aligns capacity with future growth expectations. Combining this with operational efficiencies will maximize patient care quality, improve revenue, and sustain the clinic's reputation as a leading orthopedic practice in Atlanta.

References

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