An analysis of the processing of patients in a rural medical care delivery system.

A study of the processing of patients at the rural clinic of a medical care delivery system was done to describe quantitatively the movement of patients from their arrival to their departure. The data collected provided a statistical summary of the sequence and duration of observed events in the medical care process as they related to the patients. An analysis of 485 patients visits that were observed on 60 random days during a 12-month period showed that patient arrival rates were generally higher during the morning. The average visit lasted 74 minutes; 94 percent of this time was spent in the waiting and examination rooms. The period that that the patient spent unattended by clinic personnel represented three-fourths of the average patient's total time in the delivery system. Data analysis indicated that if patients were admitted to an unoccupied examination room as soon as possible after their arrival and if standing orders for the family nurse practitioner were expanded, a significant reduction would occur in the average patient's unattended visit time.