The Operational Design of a New Heart Center Clinic

Lucile Packard Children’s Hospital (LPCH) is home to the premier pediatric heart center on the west coast, working with some of the most challenging cases. LPCH is working to design a new operational model for the Heart Center Clinic. The goals are: 1) to increase capacity by 15% with existing MD/APP staff; and 2) to provide high quality care while actively managing clinic bandwidth, including temporary closure of specific providers to new patients, and proactive addition of new clinics when they lack sufficient capacity.

Our goal is to aid the LPCH Heart Center Clinic in performing to its maximum capacity. There are opportunities to decrease wait-times, improve process flows, and allow providers to work to the top of their license As the Heart Center approaches renovations to its facility our goal is to create a model for optimizing the patient flow and achieve greater understanding of what the system would look like with the addition of providers or rooms.

We generated both an accurate model and a user-friendly interface for the model. The model captures variations by day of week, appointment type, and the appointment step (clinic, ekg, echo, vitals, or reception). The user friendly input section, allows the user to enter in ideal values or values that my occur with renovations or room closures. It provides an intuitive comparison of the wait and service times for the allocated changes. In addition, we were able to identify the key factor in long wait-times, variance in length. The two steps in an appointment with the largest variance, ECHO and clinic, see the longest wait-times, especially when paired together. For appointments without both ECHO and Clinic wait-times across all appointment types seem to decrease. We therefore suggest that the appointments with ECHO and Clinic be spread across the dates not to exceed a maximum of 10 per day.