receive a non-technical consultation and patients that
receive a technical consultation. Providing the full service
process (i.e., administration, consultation, pre- and
after-consultation services), three types of organizational
members were involved: the physicians, the nurses and
the secretaries. While each department employs secretaries
for the execution of administrative tasks, physicians
for the consultation services and nurses for the pre- and
after-consultation services, the Gastroenterology department
employs mainly nurses for the execution of technical
consultations. Furthermore, we did not include the cost of
physicians into the total clinic’s labour costs as Belgium
has a mixed, public–private health care system with state-organized
fee-for service reimbursements.
The activity data were gathered through direct observation
and multiple interviews with both the physicians (i.e.
department heads) and outpatient clinic managers. Cost
data were obtained from the outpatient clinic’s and the hospital’s
accountants. In order to derive the time equations
for the TDABC model, we needed estimates of the required
time to perform one activity. For that reason, we registered
by stopwatch the different time consumptions for all relevant
activities. Registration of the times was done during
1 week for the Urology and Gastroenterology departments
(making use of decentralized secretariats) and 2 weeks for
the Plastic Surgery, Nose-Throat and Ears and Dermatology
departments (making use of a centralized secretariat). In
order to obtain consistent results, new time registrations
were performed 3 months later. Comparing the results of
both periods, no statistically different results were found.
After having collected all data, a TDABC model was developed
for the non-technical and technical consultations of
the five different departments within the outpatient clinic.