The Ibn Hayyan PHC is a busy Primary Health Center that includes an array of services including primary care, vaccination, health coaching, school health, obesity, dental, pediatrics, smoking cessation, and maternity care. In addition, on-site lab draw and point of care lab testing are available. 83% of the patients coming to the center have a prescheduled appointment, while the remaining 17% have walk-in needs. Value stream mapping observations of the pre-scheduled patient experience reveal the following: • The registration process (1’ 21”) can be impacted by variability in demand throughout the day causing long ques. In addition, the lack of patients having an ID, elderly patient confusion, along with a mismatch between appointment needs and the appointment type in the HIS system. These defects result in staff members troubleshooting, dissatisfied patients and longer waiting. • The vitals process (2’ 00”) includes patient verification, obtaining height, weight, BP and temperature. Observations reveal variation in completing the full vitals work-up (height, weight, blood pressure and temperature) with a reliance on patient reporting. Pulling patients to the vitals process is variable (median wait of 11’). At times, patients report confusion on which side of the clinic to wait. • The wait time to see the provider following vitals is highly variable ranging from 4’ 41” to over 75’. Patients are unaware of the expected wait and can grow frustrated and may leave without being seen. Data reveals 62% of patients wait 5 minutes or more beyond their scheduled appointment time. • The visit with the provider (median time of 11’09”) is impacted by variability in sending referrals, invisibility of med lists, long-lead times for lab results, and a lack of clear care pathways for common conditions.

Huda Abdulrahman Mohaini has completed his MD from Arabian Gulf University in Bahrain , Suadi Board in Family Medicine from Saudi commission for health Specialties in Saudi Arabia & Arab Borad in family medicine from The Arab Board of health specialties in Syria . she is the Chief of primary health care centers in eastern health cluster .She has participated in publishing books about Primary