Outpatient appointment scheduling in presence of seasonal walk-ins

This study investigates appointment systems (AS), as combinations of access rules and appointment-scheduling rules, explicitly designed for dealing with walk-in seasonality. In terms of ‘access rules’, strategies are tested for adjusting capacity through intra-week, or monthly seasonality of walk-ins, or their combined effects. In terms of ‘appointment rules’, strategies are tested to determine which particular slots to double-book or leave open in cases where seasonal walk-in rates exceed or fall short of the overall yearly rate. In that regard, this study integrates capacity and appointment decisions, which are usually addressed in an isolated manner in previous studies. Simulation optimization is used to derive heuristic solutions to the appointment-scheduling problem, and the findings are compared in terms of in-clinic measures of patient wait time, physician idle time and overtime. The goal is to provide practical guidelines for healthcare practitioners on how to best design their AS when seasonal walk-ins exist.

[1]  Diwakar Gupta,et al.  A Sequential Bounding Approach for Optimal Appointment Scheduling , 2003 .

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

[3]  B. Taylor,et al.  Patient use of a mixed appointment system in an urban practice. , 1984, British medical journal.

[4]  J. Vissers,et al.  Selecting a Suitable Appointment System in an Outpatient Setting , 1979, Medical care.

[5]  Kum Khiong Yang,et al.  A new appointment rule for a single-server, multiple-customer service system , 1998 .

[6]  Paulien M. Koeleman,et al.  Optimal outpatient appointment scheduling with emergency arrivals and general service times , 2012 .

[7]  S N Forjuoh,et al.  Open-access appointment scheduling in family practice: comparison of a demand prediction grid with actual appointments. , 2001, The Journal of the American Board of Family Practice.

[8]  Edieal J. Pinker,et al.  Reserving Capacity for Urgent Patients in Primary Care , 2011 .

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

[10]  Sergei V. Savin,et al.  Managing Patient Appointments in Primary Care , 2013 .

[11]  L. Green,et al.  Reducing Delays for Medical Appointments: A Queueing Approach , 2008, Oper. Res..

[12]  T. Rohleder,et al.  Outpatient appointment scheduling with urgent clients in a dynamic, multi‐period environment , 2004 .

[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]  Ger Koole,et al.  Optimal outpatient appointment scheduling , 2007, Health care management science.

[15]  Stephen R. Lawrence,et al.  APPOINTMENT SCHEDULING WITH OVERBOOKING TO MITIGATE PRODUCTIVITY LOSS FROM NO-SHOWS , 2007 .

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

[17]  Nan Liu,et al.  Dynamic Scheduling of Outpatient Appointments Under Patient No-Shows and Cancellations , 2010, Manuf. Serv. Oper. Manag..

[18]  A. Virji,et al.  A study of patients attending without appointments in an urban general practice. , 1990, BMJ.

[19]  Jay M. Rosenberger,et al.  A data-integrated simulation-based optimization for assigning nurses to patient admissions , 2010, Health care management science.

[20]  Thomas R Rohleder,et al.  Modeling patient service centers with simulation and system dynamics , 2007, Health care management science.

[21]  Kenneth J. Klassen,et al.  Improving Performance in Outpatient Appointment Services with a Simulation Optimization Approach , 2009 .

[22]  Yue Zhou,et al.  Using simulation to improve outpatient appointment system with minimum change , 2008, SpringSim '08.

[23]  Diwakar Gupta,et al.  Revenue Management for a Primary-Care Clinic in the Presence of Patient Choice , 2008, Oper. Res..

[24]  Grisselle Centeno,et al.  Emergency departments nurse allocation to face a pandemic influenza outbreak , 2007, 2007 Winter Simulation Conference.

[25]  R. H. Smith.  Optimization for Simulation : Theory vs . Practice , 2002 .

[26]  Ronald L. Rardin,et al.  Matching daily healthcare provider capacity to demand in advanced access scheduling systems , 2007, Eur. J. Oper. Res..

[27]  R. Hall,et al.  Patient flow : reducing delay in healthcare delivery , 2006 .

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

[29]  Osman Balci,et al.  Modeling and analyzing a physician clinic environment using discrete-event (visual) simulation , 2001, Comput. Oper. Res..

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

[31]  Sue Herriott,et al.  Reducing Delays and Waiting Times With Open-Office Scheduling , 1999 .

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

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

[34]  Ihsan Sabuncuoglu,et al.  Simulation optimization: A comprehensive review on theory and applications , 2004 .

[35]  Edward J. Rising,et al.  A Systems Analysis of a University-Health-Service Outpatient Clinic , 1973, Oper. Res..

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

[37]  L. Green,et al.  Providing timely access to care: what is the right patient panel size? , 2007, Joint Commission journal on quality and patient safety.

[38]  Averill M. Law,et al.  Simulation Modeling and Analysis , 1982 .

[39]  J. Kranenburg,et al.  The prospect of walk-in for the CT department of AMC , 2009 .

[40]  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.

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

[42]  N. Bailey.  A Study of Queues and Appointment Systems in Hospital Out‐Patient Departments, with Special Reference to Waiting‐Times , 1952 .

[43]  Dennis C. Dietz,et al.  Minimizing expected waiting in a medical appointment system , 2000 .

[44]  Paul Intrevado,et al.  Effects of clinical characteristics on successful open access scheduling , 2007, Health care management science.

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

[46]  Lawrence W. Robinson,et al.  A Comparison of Traditional and Open-Access Policies for Appointment Scheduling , 2010, Manuf. Serv. Oper. Manag..

[47]  R. Hall.  Patient flow : reducing delay in healthcare delivery , 2006 .

[48]  Jason R. W. Merrick,et al.  Using simulation-optimization to construct screening strategies for cervical cancer , 2010, Health care management science.

[49]  Michael C. Fu,et al.  Feature Article: Optimization for simulation: Theory vs. Practice , 2002, INFORMS J. Comput..

[50]  R. M. Fujimoto,et al.  SIMULATION ANALYSIS OF AN OUTPATIENT DEPARTMENT OF INTERNAL MEDICINE IN A UNIVERSITY HOSPITAL , 2006 .

[51]  Thomas R Rohleder,et al.  Rolling Horizon Appointment Scheduling: A Simulation Study , 2002, Health care management science.

[52]  Emre A. Veral,et al.  Assessment of patient classification in appointment system design , 2008 .

[53]  Diwakar Gupta,et al.  Adaptive Appointment Systems with Patient Preferences , 2011, Manuf. Serv. Oper. Manag..

[54]  M. Brandreth,et al.  A simulation-based study of a NHS Walk-in Centre , 2005, J. Oper. Res. Soc..

[55]  J. Wijngaard,et al.  The outpatient appointment system: Design of a simulation study , 1979 .