Question 1:

The Seneca Medical Center (SMC) emergency room is currently organized so that all the patients
register through an initial check-in (or registration) process which takes, on average, 2 minutes per
patient. At his or her turn, each patient is seen by a doctor and then exits the process, either with a
prescription or with admission to the hospital. Currently, 50 people per hour arrive at the emergency
room, 10% of whom are admitted to the hospital. On average 30 people are waiting to be registered
and 40 are registered and waiting to see a doctor. When a doctor sees the patient, an initial 3-minute
exam determines whether patient simply needs a prescription or the patient needs to be admitted to the
hospital. If the patient only needs a prescription, it takes an additional 2 minutes of the doctors time
to complete the formalities. On the other hand, if the patient needs to be admitted to the hospital, it
takes another 27 minutes of the doctors time to conduct additional tests.
a. Draw a process flow diagram for the process described above.
b. On average, how long does a patient stay in the overall process (you may assume 50 people per
hour is steady state)?
c. On average, how many patients are being examined by doctors?

Solution 1:
Potential admits
a. The Process Flow: 10%

Buffer 1 Registration Buffer 2 Doctor

R:

50 patients/hour T1: 3 + 2 minutes
T = 2 minutes T2: 3 + 27 minutes
30
I1: I2: 40


Simple prescription
90%

Here,

R: Flow Rate of Patients

Buffer 1: Waiting station before registration
Buffer 2: Waiting station before seeing the doctor
I1: Number of patients waiting at Buffer 1
I2: Number of patients waiting at Buffer 2
T: Time taken to complete registration
T1: Time taken by the doctor to give simple prescription
T2: Time taken by the doctor to complete additional tests before admitting

b. To find the average flow times, we use Little's law at each activity for which the flow time is
unknown:

Buffer 1: R = 50/hr (both flow units go through there), I1 = 30, so that waiting time in Buffer 1 = T =
I1/R = 30/50 hr = 0.60 hours = 36 minutes.

Registration: flow time T = 2 min

Buffer 2: R = 50/hr (both flow units go through there), I2 = 40, so that waiting time in Buffer 2 = T =
I2/R = 40/50 hr = 0.80 hours = 48 minutes.

Doctor time:
Time required for initial screening: 3 minutes
depends on the flow unit:

Potential admits: T2 = 3 + 27 minutes

Simple prescription: T1 = 3 + 2 minutes

Now we have everything to find the total average flow times: find the critical path for each flow unit.
In this case, each flow unit only has one path, so that is the critical path. We find its flow time by
adding the activity times on the path:

For a potential admit, average flow time (buffer 1 + registration + buffer 2 + doctor) = 36 + 2 + 48 + 3
+ 27 = 116 minutes

For a person ending up with a prescription, average flow time (buffer 1 + registration + buffer 2 +
doctor) = 36 + 2 + 48 + 3+ 2 = 91 minutes.

We know the flow time of each flow unit. The average flow time over all flow units is the weighted
average: 10% of total flow units spend 113 minutes while 90% spend 88 minutes. Thus, the grand
average is:

T = 10% * 116 + 90% * 91 = 93.5 minutes.

c.
Those that are potential admits: flow rate = 50*10% = 5/hr.
Those that get a simple prescription: flow rate = 50*90% = 45/hr.

Potential admits: R = 5 patients/hr, T = 30 min = 0.5 hr, thus, I = RT = 5/hr*0.5 hr = 2.5 patients
Simple prescription: R = 45 patients/hr, T = 5 min = 0.0833 hr, thus I = RT = 45*0.0833 = 3.75
patients

Thus, total inventory at the doctor is 2.5 + 3.75 = 6.25 patients.

Question 2:

M.M. Sprout, a catalog mail-order retailer has one customer service representative (CSR) to take
orders at an 800 telephone number. If the CSR is busy, the next caller is put on hold. For simplicity
assume that any number of incoming calls can be put on hold and that nobody hangs up in frustration
over a long wait. Suppose that, on average one call comes in every four minutes and that it takes CSR
an average of 3 minutes to take an order. Assume that the inter-arrival times are exponentially
distributed and that the activity times have a standard deviation of 5 minutes.

a. Compute the proportion of time the CSR will be busy.

b. Estimate the average time that a customer will be on hold.
c. Calculate the average number of customers on line (i.e on hold and in service).

Solution 2:

a. Here, a: Average inter-arrival time = 4 minutes

p: Average processing time (activity time) per work unit = 3 minutes

u: Capacity utilization = (demand rate) / (capacity) = (1/a) / (1/p) = 0.75

So, the CSR will be busy 75% of her time.

b.
ca: coefficient of variation of inter-arrival time = (standard deviation of inter-arrival time) / (average
inter-arrival time) = (4/4) = 1
cp: coefficient of variation of processing time = (standard deviation of processing time) / (average
processing time) = (5/3) = 1.6667

If Wq is the average time that a customer will be on hold, then -

So, Wq = 3 * 0.75/0.25 * 1.89

= 17 minutes

c.

Average number of customers on hold, Iq = Wq * Demand Rate

= 17 * (1/4)
= 4.25

Average number of customers receiving service, = 0.75

Calculate the average number of customers on line (i.e on hold and in service) = 4.25 + 0.75 = 5