Using simulation to examine appointment overbooking schemes for a medical imaging center

In this paper, we present an appointment scheduling problem faced by a medical imaging center in a major hospital in Macau. We developed an empirically calibrated simulation model to represent the appointment and medical diagnosis procedure as a multi-server queuing network with multiple patient classes. Four appointment overbooking schemes are proposed to compensate for patient no-shows and unpunctuality. The focus of this study is to integrate overbooking schemes with existing appointment rules to improve the operational efficiency of the center. Simulation results show that our proposed overbooking schemes significantly enhance the performance of the center. Compared with the current practice, the best performing overbooking scheme reduces the overtime by 58.32% and the idle time by 23.65%, increases the number of patients served by 15.9%, while still ensuring that patient waiting times remain acceptable.

[1]  Taesik Lee,et al.  Outpatients appointment scheduling with multi-doctor sharing resources , 2010, Proceedings of the 2010 Winter Simulation Conference.

[2]  Thomas R. Rohleder,et al.  Scheduling outpatient appointments in a dynamic environment , 1996 .

[3]  P. Patrick Wang,et al.  Optimally scheduling N customer arrival times for a single-server system , 1997, Comput. Oper. Res..

[4]  J. D. Welch,et al.  Appointment systems in hospital outpatient departments. , 1952, Lancet.

[5]  Kenneth J. Klassen,et al.  Strategies for Appointment Policy Design with Patient Unpunctuality , 2014, Decis. Sci..

[6]  Lawrence W. Robinson,et al.  Scheduling doctors' appointments: optimal and empirically-based heuristic policies , 2003 .

[7]  Emre A. Veral,et al.  OUTPATIENT SCHEDULING IN HEALTH CARE: A REVIEW OF LITERATURE , 2003 .

[8]  Michael Pinedo,et al.  Appointment scheduling with no-shows and overbooking , 2014 .

[9]  Kumar Muthuraman,et al.  Sequential clinical scheduling with patient no-shows and general service time distributions , 2010 .

[10]  M. Pike,et al.  Appointment Systems in Out-patients?? Clinics and the Effect of Patients?? Unpunctuality , 1964 .

[11]  C. Conklin,et al.  Psychotherapy appointment no-shows: rates and reasons. , 2010, Psychotherapy.

[12]  Emre A. Veral,et al.  Designing appointment scheduling systems for ambulatory care services , 2006, Health care management science.

[13]  Norman T. J. Baii.  A STUDY OF QUEUES AND APPOINTMENT SYSTEMS IN HOSPITAL OUT-PATIENT DEPARTMENTS, WITH SPECIAL REFERENCE TO WAITING-TIMES , 1952 .

[14]  Kum Khiong Yang,et al.  A universal appointment rule in the presence of no-shows and walk-ins , 2012 .

[15]  A. Soriano,et al.  Comparison of Two Scheduling Systems , 1966, Oper. Res..

[16]  Hon-Shiang Lau,et al.  Minimizing total cost in scheduling outpatient appointments , 1992 .

[17]  Kumar Muthuraman,et al.  A stochastic overbooking model for outpatient clinical scheduling with no-shows , 2008 .

[18]  Stephen R. Lawrence,et al.  Clinic Overbooking to Improve Patient Access and Increase Provider Productivity , 2007, Decis. Sci..

[19]  Refael Hassin,et al.  Scheduling Arrivals to Queues: A Single-Server Model with No-Shows , 2008, Manag. Sci..

[20]  Soemon Takakuwa,et al.  Outpatient appointment scheduling in a multi facility system , 2008, 2008 Winter Simulation Conference.

[21]  Stephen R. Lawrence,et al.  Appointment Overbooking in Health Care Clinics to Improve Patient Service and Clinic Performance , 2012 .

[22]  Ronald E. Giachetti,et al.  A Stochastic Mathematical Appointment Overbooking Model for Healthcare Providers to Improve Profits , 2006, IEEE Transactions on Systems, Man, and Cybernetics - Part A: Systems and Humans.

[23]  Diwakar Gupta,et al.  Appointment scheduling in health care: Challenges and opportunities , 2008 .

[24]  Ji Lin,et al.  Clinic scheduling models with overbooking for patients with heterogeneous no-show probabilities , 2010, Ann. Oper. Res..

[25]  Nan Liu.  Appointment scheduling in health care , 2009 .

[26]  Jonathan Shapiro,et al.  Psoriasis and dyslipidaemia: a population-based study. , 2008, Acta dermato-venereologica.

[27]  Tilman Steinert.  Non›attendance at general practices and outpatient clinics , 2001 .

[28]  F. Al-Shamali,et al.  Author Biographies. , 2015, Journal of social work in disability & rehabilitation.

[29]  Ming Guo,et al.  Outpatient clinic scheduling - a simulation approach , 2004, Proceedings of the 2004 Winter Simulation Conference, 2004..

[30]  T. Cox,et al.  Optimising the queuing system for an ear, nose and throat outpatient clinic , 1985 .