Sample report. Northfield Foot & Ankle is a fictional practice and every number here is illustrative. This page shows the format and depth of a real Rootwise Consulting report. Real reports never include patient-identifying information.

Full Clinic Assessment · Written Report

Northfield Foot & Ankle

Patient experience, patient flow, and operational efficiency assessment

Practice
Podiatry · 1 location · 3 podiatrists
Team observed
4 medical assistants · 2 front desk · 1 X-ray tech
On site
5 clinic days, Monday–Friday
Prepared by
Dr. Elise Matichak, DPM, MHSA, MSMEd
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01Executive Summary

A routine visit takes about an hour, and roughly half of it is waiting.

Northfield is a busy clinic with a capable team, and patients like the care they get. Most of the lost time is in the waiting. Patients wait twice during a routine visit, and those waits build on each other until the afternoon sessions run long.

~64 mintypical check-in to checkout time for a routine visit
~50%of that time spent waiting
4 of 5afternoon sessions ran 40+ minutes past schedule
21%of patients who needed a follow-up left without one booked

What’s holding the clinic back

  1. One X-ray room, three schedules. About 38% of visits need imaging, and in the morning rush those patients often wait 10–15 minutes in the hallway.
  2. The schedule template doesn’t match the work. Wound care is booked in 15-minute slots, but patients spend about 27 minutes in the exam room.
  3. Several small handoffs slow every visit. Providers aren’t told when rooms are ready, kits are gathered from three storage areas, and paper intake gets re-typed into the EHR.

Where to start

  1. Four quick wins this month that need little or no new spending: standing imaging orders, a room-ready signal, pre-packed kits, and a short check-in script for days when a provider is running behind.
  2. Rebuild the schedule template around how long visits actually take, starting with wound care.
  3. Book follow-ups before patients leave the room instead of chasing them by phone later.

Estimated impact

Recovering 35–45 minutes per provider per day creates room for about 2 more visits per provider, every clinic day, without longer hours.

Where the 35–45 minutes per provider comes from
F2 · Wound care blocks~15–18 minAbout 1.5 wound visits per provider per day, each running ~12 minutes past its slot
F1 · Standing imaging orders~8–10 minLess provider time waiting on films during the morning rush
F3 · Room-ready signal~6–8 minA few minutes saved each time a ready room goes unnoticed, several times a day
O1 · Pre-packed kits~5–7 minFaster rooming for routine foot care, so providers start sooner
Total~34–43 minRounded to 35–45 minutes per provider per day

At 3 providers, about $120 collected per visit, and about 230 clinic days a year, that’s roughly $165,000 in added annual visit capacity. This is an estimate; actual results depend on demand, payer mix, and how fully the changes are adopted.

02Patient Flow Map

Where the 64 minutes go

Approximate times for a routine follow-up visit. The total comes from the clinic’s own check-in and checkout timestamps, and the split between steps is my estimate from watching the clinic run. The podiatrist is with the patient for roughly 11 of the 64 minutes.

Routine visit, approximate minutes by step
  1. 6minCheck-inPaper intake for new patients; insurance verified at the desk.
  2. 21minWaiting room⚠ BottleneckRises to 34 min after 2 p.m. as delays stack up.
  3. 8minRooming & intakeVitals, med review, shoes and socks off. About 3 of these minutes go to gathering supplies.
  4. 12minWaiting for provider⚠ BottleneckRooms were often ready before the provider knew.
  5. 11minProvider visitExam, treatment, and documentation.
  6. 6minCheckoutCopay and scheduling; follow-ups often not booked.

Imaging branch · 38% of visits

Visits that need X-ray add roughly 15 minutes of hallway waiting plus about 5–10 minutes for the films and review, so those visits run closer to 85–90 minutes check-in to checkout. Between 9 and 11 a.m., up to four patients were queued for the one X-ray room at once.

View flow data as a table
StepTypeApprox. minutes
Check-inCare & process6
Waiting roomWaiting21
Rooming & intakeCare & process8
Waiting for providerWaiting12
Provider visitCare & process11
CheckoutCare & process6
Total33 waiting / 31 care64
Imaging branch (38% of visits)~15 waiting + 5–10 imagingabout +20–25

03Findings & Recommendations

Eight findings, each with a fix

Each finding shows what I saw, why it matters, and what to change.

Patient Flow

F1

Three providers share one X-ray room with no imaging protocol

Quick win
Evidence
About 38% of visits needed imaging. Between 9 and 11 a.m., imaging patients regularly waited 10–15 minutes in the hallway; later in the day the wait was short. Imaging was ordered only after the provider saw the patient.
Impact
Providers wait on films, rooms stay occupied, and morning delays carry into the afternoon.
Recommendation
Use standing imaging orders at check-in for defined visit types (new injury, post-op weeks 2 and 6, fracture follow-up). Stagger new-patient slots so the three providers don’t all need imaging in the same hour.
Owner
Medical director, X-ray tech
F2

Wound care is booked for 15 minutes but takes about 27 in the room

30–60 days
Evidence
From observation, wound care patients spent about 27 minutes in the exam room (dressing removal, debridement, measurement, and re-dressing), but they’re booked in 15-minute slots. The clinic sees 4–5 of these visits a day, spread across all three providers.
Impact
Each wound visit puts the schedule about 12 minutes behind. It’s the main reason afternoon sessions ran 40+ minutes over on 4 of 5 days.
Recommendation
Rebuild templates using observed room times for each visit type. Move wound care into dedicated 30-minute blocks with a prepared wound cart.
Owner
Practice manager, providers
F3

Providers don’t know when a room is ready

Quick win
Evidence
Patients often waited 10 minutes or more in the exam room. Several times a day, the room was ready and the provider was free but hadn’t been told.
Impact
Avoidable patient wait, and providers interrupt charting to go check doors.
Recommendation
Add a room status signal (door flags or the EHR room board) and a rule: MA flags “ready” the moment intake is done.
Owner
MA lead

Patient Experience

E1

No one tells waiting patients the clinic is running behind

Quick win
Evidence
Not knowing how long the wait would be was the top frustration in 9 of 46 patient surveys. Front desk staff fielded about 14 “how much longer?” questions a day.
Impact
Waits feel longer than they are, check-in gets interrupted, and patients rate the visit lower.
Recommendation
Give the front desk a simple script: when a provider is running behind, let each patient know quietly at check-in and offer to text them when their room is ready. An MA checks in with anyone who has been waiting more than 20 minutes.
Owner
Front desk lead
E2

Home-care instructions are given verbally only

30–60 days
Evidence
1 in 4 surveyed patients weren’t sure of their next steps at home (dressing changes, orthotic break-in, post-injection care). MAs re-explained instructions by phone about 6 times a day.
Impact
Callbacks, avoidable complications, and patients who feel rushed.
Recommendation
Write plain-language after-visit instruction sheets for the 8 most common visit types, and hand them out or send them through the portal at checkout.
Owner
Clinical lead, MAs

Operational Efficiency

O1

Debridement kits are assembled from three storage areas, one visit at a time

Quick win
Evidence
About 3 minutes of MA time per routine foot care visit, across about 24 such visits a day.
Impact
About 70 minutes of MA time a day, and rooming runs longer.
Recommendation
Move high-use supplies into one central area near the exam rooms, keep a backup area that restocks it and shows at a glance what’s running low, and put low-use items in a separate spot. Pre-pack standard kits from the central area at the end of each day, and give one person ownership of restocking.
Owner
MA lead
O2

Follow-ups aren’t booked before patients leave

30–60 days
Evidence
21% of patients who needed a follow-up left without one. Staff later spent an average of 2.6 calls per patient reaching them.
Impact
Gaps in care, lost visits, and hours of phone time each week.
Recommendation
The MA books the follow-up in the exam room before the patient walks out, and checkout confirms it. Track the “booked before leaving” rate every week.
Owner
MAs, front desk
O3

Paper intake forms are re-typed into the EHR

Long-term
Evidence
About 4 minutes of front desk time per new patient, with transcription errors in 3 of 20 charts sampled.
Impact
Longer check-in lines at peak times and data-quality risk.
Recommendation
Send digital intake before the visit with appointment reminders, and keep a tablet option at the desk for patients who prefer it.
Owner
Practice manager

What’s Working Well

Things to keep doing

Not everything needs fixing. These are areas I looked at closely and found in good shape.

  • Phones

    Calls were answered quickly, and hold times stayed short even on Monday morning. No changes needed.

  • Prior authorizations

    One staff member owns prior auths and keeps a clear tracking log. I didn’t see a backlog.

  • Faxes and referrals

    Incoming faxes are sorted twice a day, which works at the clinic’s current volume.

  • Teamwork

    MAs anticipate most providers’ procedure setups, and staff cover for each other without being asked. Patients rated the care itself highly in surveys.

04Action Plan

Action plan by timeframe

Weeks 1–2

Quick wins

  • F1 Standing imaging orders Medical director
  • F3 Room-ready signal MA lead
  • O1 Central supply area, backup stock & pre-packed kits MA lead
  • E1 Check-in script & wait check-ins Front desk lead

Days 30–60

Structural changes

  • F2 Rebuild schedule templates; wound care blocks Practice manager
  • O2 Book follow-ups in the room MAs, front desk
  • E2 After-visit instruction sheets Clinical lead

Days 60–90+

Investments

  • O3 Digital pre-visit intake Practice manager
  • Compare check-in to checkout times against this baseline Practice manager

How we’ll know it worked

MeasureBaseline90-day target
Check-in to checkout time, routine visit (from your timestamps)~64 min~50 min
Share of visit spent waiting (estimated)~50%~35%
Peak-hour imaging wait (spot checks)10–15 minUnder 5 min
Afternoon sessions running 40+ min over4 of 5 days1 of 5 days or fewer
Follow-ups booked before leaving79%95%

Methods

How this report was built

  • 5clinic days observed, covering every provider and session type
  • 274patient visits observed
  • 6roles shadowed: front desk, MAs, X-ray, providers, billing, and the manager
  • 11staff conversations across every role
  • 46brief patient surveys
  • 90days of schedule, no-show, and check-in/checkout data reviewed (de-identified)

Times in this report are approximate. Totals come from the clinic’s own timestamps, and step times are estimates from observation, so treat them as a guide to where the time goes, not exact measurements. Observation followed the practice’s privacy policies under a signed Business Associate Agreement. No patient names or identifying details appear in any report.

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