The clinic uses the first come first serve basis to transform incoming patients to into served customers. The clinic is likely to be using the pull systems in its production process to transform incoming patients into served customers. In a typical clinical production process, tasks and operations are linked together into a series of production flow-charts without the patients having to waste time or delay while waiting to receive attention from caregivers. In the value stream indicated above, the clinic seems to be using the first-in-first-out (FIFO) method that links the processes into a pull system. When the patient arrives at the clinic, s/he is given a form to fill personal information and describe the ailment, the form is then time stamped and placed on a tray. After completing the form, the clerk attaches it to the patient file and arranged in a stack of files based on the stamped time. Subsequently, when a nurse finishes with the current patient, the next patient is selected from the stack of files in the order of arrangement. The goal of the FIFO pull system is to ensure that the patients waiting in the queue for services remain in the system and are served in the order in which they arrived the FIFO system. The FIFO system limits the number of patients who use the service based on the time and resources available. In an ideal situation, once the FIFO system is full, the first process of admission is stopped in order to avoid overwhelming the nurse practitioner in the diagnosis and treatment of the patients. However, this is difficult in this scenario, given that the patients walk into the clinics without appointments and reservations.
The main factors that patients view as critical-to-quality (CTQ) when they visit the clinic include satisfaction with the treatment they receive from the hospital, high nursing response rate in serving the patient and time spend in the queues while waiting to receive treatment from practicing nurse or on duty MD. These