ABSTRACT
BACKGROUND AND OBJECTIVE: Evaluating the time taken at each step in a patient office visit is important for physicians and clinical staff for clinic workflow improvements. Very little data exists on efficiency that is not self-reported by physicians. Employees often have perceptions of the efficiency of a clinic without supporting data. This study examined whether employee perceptions of the amount of patient time spent at various points in the visit matched observed times. METHODS: Observational cohort study methods and a cross-sectional survey were used in the fall of 2017 in a family practice residency outpatient clinic. Clinical staff (physicians and support staff) were surveyed for their perceptions of patients' time spent at each checkpoint in an office visit. A total of 885 visits were recorded, with 705 being included after review. Time spent at various steps, appointment type, and clinician years of experience were assessed with t-test for statistical significance. RESULTS: The anonymous clinic survey had a 75.5% response rate (37/49) and showed "rooming patients" and "waiting in the exam room to be seen" were the two areas that took longer than expected. The observed data confirmed this perception, showing that rooming and waiting in the exam room each took longer than the staff expected. These values were also greater than available national average times. There was a significant correlation between physician training year and visit length. There was no correlation for nursing experience and patient visit times. CONCLUSIONS: The staff-perceived inefficiencies correlated with observed inefficiencies. Addressing these problems would improve patient care and overall clinic workflow.
ABSTRACT
Laser processed Ti6Al4V alloy samples with total porosities of 0%, 10% and 20% have been subjected to torsional loading to determine mechanical properties and to understand the deformation behavior. The torsional yield strength and modulus of porous Ti alloy samples was found to be in the range of 185-332 MPa and 5.7-11 GPa, respectively. With an increase in the porosity both the strength and the modulus decreased, and at 20% porosity the torsional modulus of Ti6Al4V alloy was found to be very close to that of human cortical bone. Further, the experiments revealed clear strain hardening and ductile deformation in all the samples, which suggests that the inherent brittleness associated solid-state sintered porous materials can be completely eliminated via laser processing for load bearing metal implant applications.
