Applying Computer Simulation Modelling to Minimizing Appointment Lead-Time in Elderly Outpatient Clinics: A Case Study

Appointment lead-time is a pivotal parameter in elderly outpatient clinics. In this regard, delayed medical care may represent complications in the elderly population and the development of more severe diseases. However, healthcare managers are not skilled in methods effectively reducing waiting times. Therefore, this paper presents the computer simulation modelling to tackle this problem. In this regard, the real-world system was initially simulated and then, three improvement scenarios were designed and validated operationally and financially. The results evidenced that Scenario 2 was the best choice since it provided a low investment per reduced day and a significant reduction (47.1%) regarding the probability of waiting for more than 8 days per appointment. With this proposal, the quality of medical care in elderly population can be meaningfully increased and decision-making process can be effectively supported.

[1]  Giovanni Felici,et al.  Integrating simulation and optimisation in health care centre management , 2003, Eur. J. Oper. Res..

[2]  R. Puri,et al.  Clinic , 1907, The American journal of dental science.

[3]  W C A Pereira,et al.  Discrete-event computer simulation methods in the optimisation of a physiotherapy clinic. , 2011, Physiotherapy.

[4]  J. Donovan,et al.  Patient flow within UK emergency departments: a systematic review of the use of computer simulation modelling methods , 2017, BMJ Open.

[5]  S. Elkhuizen,et al.  Using computer simulation to reduce access time for outpatient departments , 2007, BMJ Quality & Safety.

[6]  MO Oche,et al.  Determinants of Patient Waiting Time in the General Outpatient Department of a Tertiary Health Institution in North Western Nigeria , 2013, Annals of medical and health sciences research.

[7]  Ronald E. Giachetti,et al.  A simulation study of interventions to reduce appointment lead-time and patient no-show rate , 2008, 2008 Winter Simulation Conference.

[8]  Jairo R. Montoya-Torres,et al.  Coupling ant colony optimization and discrete-event simulation to solve a stochastic location-routing problem , 2013, 2013 Winter Simulations Conference (WSC).

[9]  Jingshan Li,et al.  A simulation study to improve quality of care in the emergency department of a community hospital. , 2012, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[10]  Thomas R Rohleder,et al.  Using simulation modeling to improve patient flow at an outpatient orthopedic clinic , 2011, Health care management science.

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

[12]  Shaowen Qin,et al.  Hospital Event Simulation Model: Arrivals to Discharge-Design, development and application , 2016, Simul. Model. Pract. Theory.

[13]  Zhecheng Zhu,et al.  Analysis of Factors Causing Long Patient Waiting Time and Clinic Overtime in Outpatient Clinics , 2012, Journal of Medical Systems.

[14]  Chris D. Nugent,et al.  Reducing Appointment Lead-Time in an Outpatient Department of Gynecology and Obstetrics Through Discrete-Event Simulation: A Case Study , 2016, UCAmI.

[15]  Miguel A. Ortiz,et al.  Using Computer Simulation to Improve Patient Flow at an Outpatient Internal Medicine Department , 2016, UCAmI.

[16]  Wagner Coelho A. Pereira,et al.  Computer simulation and discrete-event models in the analysis of a mammography clinic patient flow , 2007, Comput. Methods Programs Biomed..

[17]  Paul R. Harper,et al.  Combining discrete-event simulation and system dynamics in a healthcare setting: A composite model for Chlamydia infection , 2014, Eur. J. Oper. Res..

[18]  Heriberto Felizzola Jiménez,et al.  Reduction of Average Lead Time in Outpatient Service of Obstetrics Through Six Sigma Methodology , 2015, AmIHEALTH.

[19]  Jesus A. Jimenez,et al.  Modeling and simulation of patient admission services in a multi-specialty outpatient clinic , 2013, 2013 Winter Simulations Conference (WSC).

[20]  Martin Pitt,et al.  An analysis of the academic literature on simulation and modelling in health care , 2009, J. Simulation.