Multi-criteria decision making in outpatient scheduling

viii Chapter One Introduction 1 1.1 Patient Priority and Appointment Assignment Models for Outpatient Scheduling Decisions 5 1.2 Research Objective 6 1.3 Organization of Paper 7 Chapter Two Literature Review 8 2.1 System Modeling in Healthcare 8 2.2 Resource Scheduling 9 2.3 Patient Scheduling 10 2.4 Multi-criteria Decision Making 13 2.5 Multi-attribute Decision Making 14 2.5.1 Comparison of MADM Methods 15 2.5.2 Comparison of Weighting Methods 17 2.5.3 Saaty’s Method 18 Chapter Three Problem Statement and Approach 21 3.1 Approach 21 3.2 Criteria Generation 22 3.3 Determination of Attribute Weights 23 3.3.1 The Fundamental Scale 24 3.3.2 The Eigenvector Method 25 3.3.3 A Numerical Example 27 3.3.4 Consistency Index and Ratio 28 3.3.5 Synthesizing Judgment Matrices 29 3.4 Relative Performance Values 30 3.5 Score and Rank Alternatives 32 Chapter Four Criteria Generation and Weight Results 34 4.1 Criteria Generation 36 4.2 Determination of Relative Weights 38 4.3 Relative Value Calculations 41 iii 4.3.1 Decision #1 Relative Values and Model 43 4.3.2 Decision #2 Relative Values and Model 44 4.3.3 Decision #3 Relative Values and Model 45 Chapter Five Simulation Logic 47 5.1 Entities 48 5.1.1 Scheduled Patient Entities 48 5.1.2 Walk-in Patient Entities 53 5.1.3 Other Task Entities 54 5.2 Resources 54 5.3 Patient Entity Arrivals and Schedule Creation 55 5.4 Schedule Block Variables Sub-model 57 5.5 Scheduled Patient Arrival to Clinic System 60 5.6 Appointment Assignment and Urgent Patients 60 5.7 Processing 62 5.8 Priority 1 Assignment and Urgent Patients 63 5.9 Appointment Assignment for Late and Walk-in Patients 66 5.10 Waiting Room Queue and Priority 2 Assignment 69 5.11 Verification and Validation 70 Chapter Six Simulation Results 71 6.1 Analysis of Simulation Variables 72 6.2 Analysis of Variance and Setting Selection 73 6.3 Clinic Simulation Output Analysis 78 6.3.1 Clinic Simulation Model Analysis 79 6.3.2 Clinic and Current System Model Comparison 82 Chapter Seven Conclusions and Future Work 89 7.1 H. Lee Moffitt Case Study Conclusions 90 7.2 H. Lee Moffitt Case Study Assumptions and Conditions 91 7.3 Other Applications 92 7.4 Future Work 93 References 95 Appendices 100 Appendix A: Moffitt Clinic Observations 101 Appendix B: Interviews with 3rd floor Clinic Nurses 108 Appendix C: Responses from Clinic Operations Managers Meeting 110 Appendix D: Appointment Assignment Rules for Late and Walk-in Patients 112 Appendix E: Original Survey 113 Appendix F: Final Survey 118 Appendix G: Simulation Data 123