Walk-in Clinic

Walk-in clinic share of the total $10 million budget is 20%. Physicians salary: 25 to 55 (+18.5 %) – 40 h/w for 46 weeks (12h is WIC, 16h office app, 5h at infirmary, 7 administrative and etc) – 1 hour of reserve time to check on old patients. Nurses salary: 16 to 26 (+18.5 %)

Holyoke WIC: The most comprehensive ambulatory care out of 4 YHS WICs. 8 am to 5:30 pm (Saturday 8 to 12:45). Few emergencies. 12 treatment rooms (4 nurses and 8 doctors (3 offices, only used only when on duty)) 37400 (143 per day) patients in 1979 (67% students, 23% staff, 10% dependents and etc) Peak time between 10 to 4. 22 physicians for specific times (blocks of 3-4 hours) 150 physicians-hours available per week. 2 registered nurses and 11 nurse practitioners.( 8-hour shifts (1 hour lunch)). Nurse practitioners staffed UHS emergency room at night and on weekends. Also semi-admin duties. 45% of nurses practitioners’ hours available to treat patients in the WIC.

Pre-triage period: Front desk (fill sequentially numbered sheet)  waiting area  receptionist retrieve records (89 minutes) take the record to the medical desk ( clerk confirms info – 5 min)  clerk puts the record and the sheet in an ordered pile diagnosis by first available nurse (10 min) If need to see a doctor: back to waiting area (avg 10 min) nurse put the medical record in a pile for physicians (ff)  seen by first available physician Complaints: waiting time between sign-in and treatment.(avg 22 min, 22% more than 35 min). patients asking for specific physicians (19% of all patients) waited 40 min avg. Wait time unrelated to nature of issue. Only 40% of patients are treated completely by nureses

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Triage system (sep 1979) AVF form if emergency  gets evaluated AVF form  receptionist Check for completeness and request for records  clerk checks data  pile in tirage pile  one of two coordinators calls the patient and determine status (3-4 min)  send patients to nurse, doctor, or book an appointment....