West Coast University Student Health Services: Primary Care Clinic

The Current System

While managing the Primary Care Clinic, Joan Carwin has made it "an effort to make SHS [Student Health Services] more personalized and pro-active." Carwin was able to do this by giving students the option to choose their primary-care clinician. Doctors were also enthused with the idea since they could develop a better rapport with patients they see more often. The doctors also felt that a more personalized healthcare would lead to a higher quality of service. Personal relationships could be honed and doctors would be "able to monitor their patients' progress." Both students and doctors favored the idea of a having more personalized service.

Whenever a patient would come into the clinic as a walk-in, a triage nurse would first assess the patient's severity of injury and apply the adequate urgency to be treated. Of course, patients with a higher degree of injury were given more of a priority. After being assessed by the triage, a medical assistant would check for vital signs, file the proper paperwork, and run the necessary tests according to the clinicians. On average, the medical assistant would spend 3.5 minutes with a patient. The patient would then wait for the clinician to be available. On average, the clinician would spend 20 minutes examining the patient. Afterwards, the clinician would take 5 minutes to write out notes regarding the patient. Patients who wanted to see their specified clinician, but could not due to busyness or absenteeism, were told to come back when the clinician was available. Those patients whose clinicians were on-duty had to wait for a period of time." Over a period of six months, physicians had treated 9005 patients and nurse practitioners 6760 patients. Sixty percent of patients were walk-ins, while the rest had appointments directly with clinicians."

The ability for students to choose their primary-care clinician caused many problems for the Primary Care Clinic. For one, students were required to wait a longer period of time to see the clinician they wanted. "Sometimes they had to wait two or even three days before their clinician would be available." Students specifying clinicians that they wanted caused a bottleneck in the whole operation. The bottleneck of available clinicians caused an inefficiency in the number of patients being treated, which led to a build up in patients' waiting time.

Problems

A Change of Direction

"In the fall of 1997, the PCC was scheduled to move out of its current location in the basement of the Student Health Center facility into a new building specifically designed for the clinic." Joan Carwin pushed for a new location due to two major factors: 1.) The opening of the new WCU physicians'