Question

Dr. Steve Rosenthal has his own medical practice. He specializes in the treatment of diabetics. His staff consists of a receptionist, two nurses, a lab technician, and a dietitian. As patients enter the outer office, they check in with the receptionist. The patient then waits until called by a nurse. When called, the patient moves from the waiting room to the inner offices. The patient must weigh in and is then assigned a room. The nurse assigning the patient to a room gathers all the personal data for updating the medical records, such as insulin dosage, medication, illnesses since last visit, etc. The nurse also takes an initial blood sample for blood sugar testing and performs a blood pressure test. The patient then waits until the doctor comes in. After the doctor's conference, the nurse returns to take more blood samples, depending on what is ordered by the doctor. The patient then waits until the dietitian comes to review eating habits and talk about how to improve meal planning and weight control. The patient returns to the receptionist to pay for the office visit and to schedule the next visit.

In your response include the following:

• Identify the activities in the doctor's office that fall into process time, inspection time, move time, wait time, and storage time.
• List the activities in the doctor's office that are candidates for non value-added activities. Explain why you classify them as non value-added activities.

Answer 1

1. Activities in the doctor's office that fall into process time

• The patient must weigh in and is then assigned a room
• Dietitian review eating habits and talk about how to improve meal planning and weight control

2. Activities in the doctor's office that fall into inspection time

• The nurse takes an initial blood sample for blood sugar testing and performs a blood pressure test
• After the doctor's conference, the nurse returns to take more blood samples, depending on what is ordered by the doctor

3. Activities in the doctor's office that fall into move time

• The patient moves from the waiting room to the inner offices

4. Activities in the doctor's office that fall into wait time

• The patient then waits until called by a nurse
• The patient then waits until the doctor comes in
• The patient then waits until the dietitian comes to review

5. Activities in the doctor's office that fall into storage time

• The nurse assigning the patient to a room gathers all the personal data for updating the medical records
• The patient returns to the receptionist to pay for the office visit and to schedule the next visit

The activities in the doctor's office that are candidates for non value-added activities:

• The nurse also takes an initial blood sample for blood sugar testing and performs a blood pressure test

It is a non value added activity as later nurse again takes the blood as ordered by the doctor. Since she performs additional blood tests after the doctor's order, the activity of taking initial blood samples is non value added.