The Crimson Press Curriculum Center

First Page and the Assignment Questions:
John Neely, M.D., Chief of Pediatric Hematology/Oncology at the Penn State Children's Hospital in Hershey, Pennsylvania, arrived at work on a Monday morning in November 1996 feeling energized. On Saturday he had completed the second three-day module of a management training course for physician leaders, which had focused on operations and accounting concepts. He was thinking about how he might apply some of those concepts to issues in his department as he walked in.

No sooner had he arrived at the oncology clinic, however, than the reflective mood was broken. Rosanne Ayala, one of the nurses who staffed the clinic and infusion room, was upset.

You won't believe what happened while you were away, John. The Pediatric Practice manager came over on Friday to tell us that we would be giving globulin infusions to 80 newborns over the course of the next eight weeks. There's no way we can manage that! We've been doing more than twenty infusions a week lately - and just barely managing! Here we are, already overstretched and without even checking with us first a new program gets started. Besides, we're an oncology team and now we're being asked to do other infusions. This is just not reasonable!

Dr. Neely assured Rosanne that the infusion room predicament would be his top priority. The physicians and nurses in the group worked well together and he did not want their efforts to form an effective team to be undermined. The Pediatric Practice Manager was herself a nurse practitioner and a very able manager, so Dr. Neely felt there must be a reasonable explanation for what had happened.

Still, as Dr. Neely left the clinic he almost laughed. He had been ready to try some of those process analysis concepts, but a new crisis was not what he had in mind!

The Hematology/Oncology Infusion Room

The Penn State Children's Hospital was located in Hershey, Pennsylvania. Affiliated with the Penn State University College of Medicine and University Hospital, the Children's Hospital provided a full range of inpatient and outpatient services for children and young adults.

The infusion room, part of the Pediatric service, was the outpatient area where intravenous medication was administered to patients ranging in age from six months to twenty-some years who had complex cancer and blood problems. Originally designed just for cancer treatments, the infusion room was the only available space for outpatient infusions to be administered.

The infusion room was a large open room with four recliners used as treatment chairs (Exhibit 1). It was located adjacent to the oncology clinic and to the pharmacy which dispensed the chemotherapy drugs. Infusion room operating hours were 8:00 to 5:00, Monday through Friday. A specific physician was assigned to the infusion room Tuesday through Thursday; on Mondays no specific physician was assigned to the infusion room but whichever physician was available would supervise infusions and discharge patients as needed.

Assignment

1.   What is the capacity of the infusion room?

2.   How well is the capacity used?

3.   What factors contribute to the variation in the capacity utilization?

4.   What should Dr. Neely do?