Why a daily ratio falls short
A common way to staff an urgent care clinic is to divide daily visits by how many patients a provider can see in an hour, then fill that many provider hours. The math works for the day. It doesn't tell you where the hours should go.
Walk-in arrivals aren't flat. There's a morning rush, a quieter middle and an after-work peak. A clinic also closes, so whoever is in line at closing time is the wait your last patients remember and the overtime your staff works. The same provider hours can give a calm day or a bad evening depending on when the shifts start.
Worked example
Example assumptions, not benchmarks. A clinic open 8am to 8pm sees 48.5 patients on an average day. One MD works all 12 hours. One PA works one 8-hour shift. MD visits average 15 minutes and PA visits 20 minutes, and both vary from patient to patient. Arrivals are random around the hourly averages below.
| Hour | 8am | 9am | 10am | 11am | 12pm | 1pm | 2pm | 3pm | 4pm | 5pm | 6pm | 7pm |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patients per hour | 3 | 4 | 4 | 3.5 | 3.5 | 3.5 | 3.5 | 4 | 5 | 5.5 | 5 | 4 |
We ran the same patients through four PA schedules in QSimHealth. Each run covers a full simulated year.
| PA shift | Average wait | Worst hour |
|---|---|---|
| 8am–4pm | 16.5 min | 55 min at 7pm |
| 9am–5pm | 12.1 min | 39 min at 7pm |
| Noon–8pm | 13.3 min | 31 min at 10am |
| 8am–8pm (four more PA hours) | 6.5 min | 11 min at 6pm |
Wait is the time from arrival to the start of the visit, averaged over every patient who arrived in that hour across the year.
What the example shows
- The early shift leaves the evening to one provider. From 4pm on, arrivals run above what one MD can see, and the line grows until closing.
- The late shift moves the problem to the morning. The evening settles down, but the 9am to 11am rush now falls on the MD alone.
- No single 8-hour placement fixes both peaks here. Covering all 12 hours with the PA brings the worst hour down to 11 minutes. That's four more PA hours a day. At an example rate of $75 an hour, it's $300 a day.
Your pattern will differ. The point is that the question "should the PA start at 8 or at noon?" has a real answer for your clinic, and you can see it before you post the schedule.
Modeling your clinic in QSimHealth
- Choose the walk-in clinic facility type. It covers urgent care and retail walk-in clinics.
- Enter average arrivals for each hour you're open and zero for the hours you're closed.
- Enter MDs and PAs or NPs on duty by hour, and typical visit times for each.
- Run it, then save the result as a scenario. Change one shift, run again, and compare the two side by side with cost per day.
Providers stay on after closing until the line clears, so late-day waits show up the way they do on the floor.
Questions
How many patients per hour can an urgent care provider see?
It depends on visit length. At a 15-minute average a provider can see about four patients an hour if they are never idle, but running close to that makes waits climb fast. See patients per provider per hour for why.
Is urgent care a different facility type from a walk-in clinic?
No. In QSimHealth, urgent care and walk-in clinics use the same facility type: set hours, walk-in arrivals and a mix of MDs with PAs or NPs.
Can I model a split or overlapping PA shift?
Yes. Staffing is entered hour by hour, so any pattern of MDs, PAs and NPs you can write on a schedule can be run and compared.