Venice

CASE STUDY

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PREPARED BY Professor Kumar Rajaram, UCLA Anderson School of Management Karen Conner, MD, UCLA David Geffen School of Medicine A case by the Johnson & Johnson/UCLA Health Care Executive Program and the UCLA Anderson School of Management

Dr. Susan Fleishman, Medical Director at the Venice Family Clinic (VFC) returned to theclinic after her early morning meeting with CEO, Elizabeth Forer. It was a typically warm and sunny Southern California day as she approached the front door of the clinic. She walked past a line of six to eight people waiting to check in at security and then proceeded upstairs to the waiting room. Almost every seat was taken. The room was full of elderly people, homeless men and women, young mothers,babies, toddlers with runny noses, school-aged children watching TV and adult men and women dressed for work. Some clutched papers indicating they had been seen by either registration or a provider, but most were holding only their colorcoded cards given to them as they passed through security.

As she headed towards the patient rooms, she noticed two resident doctors holding charts and chattingabout their upcoming ski trips, one attending physician talking to a medical assistant about lab work and another on the telephone impatiently waiting on hold. A quick walk by the patient rooms showed that despite the crowd in the waiting room, only about half of the rooms had patients in them. She knew that many of the patients seen by the clinic spent hours there each visit, and that most ofthat time was spent waiting. She thought back to her meeting with Liz. She had been told that there were projections for a 26% increase in visits over the next year. How would the clinic be able to handle such a large influx of patients? She had already begun hearing grumblings from her patients about how long the waits were. How

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could operations be improved to decrease wait timesfor patients and make things flow more smoothly? She hoped that the results of the newly completed time study would be useful.

THE VENICE FAMILY CLINIC The Venice Family Clinic was founded as a storefront operation over 30 years ago with the intent to care for low-income and uninsured members of the local community. Its mission:

“to improve the health of people and communities throughaccessible, quality care” It has grown through community and volunteer support to become the largest free clinic in the country. It serves nearly 19,000 patients a year, a third of whom are children, with over 95,000 clinic visits at 4 sites. It provides vital services in primary health care; women’s health care; prenatal, well-baby and pediatric care; HIV/AIDS prevention and medical treatment; ongoingcare for chronic diseases such as asthma, diabetes and hypertension; specialty care in a variety of areas including cardiology, dermatology, ear, nose and throat and neurology. In addition, it also provides laboratory and diagnostic services as well as running its own inhouse pharmacy, dispensing medications that have either been donated to the clinic or purchased at a reduced price.

Theclinic is staffed by over 500 physician-volunteers as well as 14 staff physicians in addition to multiple medical assistants, laboratory and pharmacy personnel and administrative support. The total budget for the Venice Family Clinic exceeds $16 million and is funded through a combination of local and federal government aid and community contributions.

THE ROSE AVENUE GENERAL MEDICINE CLINIC TheRose Avenue Clinic is the flagship site of the VFC. Patients are seen in the clinic between the hours of 9:00am and 12:00pm and between 1:00 and 5:00pm. Patients must typically call at least one day ahead for an appointment, but a few spots are reserved in the schedule for urgent care or walk-in visits. The clinic sees, on average, 165 patients per day. There are usually nine physicians on duty to...