Single versus hybrid time horizons for open access scheduling

Difficulty in scheduling short-notice appointments due to schedules booked with routine check-ups are prevalent in outpatient clinics, especially in primary care clinics, which lead to more patient no-shows, lower patient satisfaction, and higher healthcare costs. Open access scheduling was introduced to overcome these problems by reserving enough appointment slots for short-notice scheduling. The appointments scheduled in the slots reserved for short-notice are called open appointments. Typically, the current open access scheduling policy has a single time horizon for open appointments. In this paper, we propose a hybrid open access policy adopting two time horizons for open appointments, and we investigate when more than one time horizon for open appointments is justified. Our analytical results show that the optimized hybrid open access policy is never worse than the optimized current single time horizon open access policy in terms of the expectation and the variance of the number of patients consulted. In nearly 75% of the representative scenarios motivated by primary care clinics, the hybrid open access policy slightly improves the performance of open access scheduling. Moreover, for a clinic with strong positive correlation between demands for fixed and open appointments, the proposed hybrid open access policy can considerably reduce the variance of the number of patients consulted.

[1]  J. De Maeseneer,et al.  Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs? , 2003, The Annals of Family Medicine.

[2]  Hector P. Rodriguez,et al.  The Effects of Primary Care Physician Visit Continuity on Patients’ Experiences with Care , 2007, Journal of General Internal Medicine.

[3]  Ateev Mehrotra,et al.  Implementing Open-Access Scheduling of Visits in Primary Care Practices: A Cautionary Tale , 2008, Annals of Internal Medicine.

[4]  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.

[5]  I. Wilson,et al.  Cost-related skipping of medications and other treatments among medicare beneficiaries between 1998 and 2000 , 2005, Journal of General Internal Medicine.

[6]  Stephen D Mallard,et al.  Same-day scheduling in a public health clinic: a pilot study. , 2004, Journal of public health management and practice : JPHMP.

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

[8]  Steven Pierdon,et al.  Implementing advanced access in a group practice network. , 2004, Family practice management.

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

[10]  Patrick J O'Connor,et al.  Key issues in transforming health care organizations for quality: the case of advanced access. , 2004, Joint Commission journal on quality and safety.

[11]  Xiuli Qu.  Development of appointment scheduling rules for open access scheduling , 2006 .

[12]  John Corlett,et al.  The outcomes of open-access scheduling. , 2004, Family practice management.

[13]  Diane H. Parente,et al.  Selling Open Access Health Care Delivery to Patients and Administrators , 2002, Health marketing quarterly.

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

[15]  Micah L Meyers.  Changing business practices for appointing in military outpatient medical clinics: the case for a true "open access" appointment scheme for primary care. , 2003, Journal of healthcare management / American College of Healthcare Executives.

[16]  Brent Armstrong,et al.  Reinventing Veterans Health Administration: Focus on Primary Care , 2005, Journal of healthcare management / American College of Healthcare Executives.

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

[18]  J. Talaga,et al.  Predicting appointment breaking. , 1995, Journal of health care marketing.

[19]  Fouad Riane,et al.  Scheduling an operating theatre under human resource constraints , 2010, Comput. Ind. Eng..

[20]  Greg D Randolph,et al.  Open Access in Primary Care: Results of a North Carolina Pilot Project , 2005, Pediatrics.

[21]  Greg Rubin,et al.  Non-attendance in general practice: a systematic review and its implications for access to primary health care. , 2003, Family practice.

[22]  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.

[23]  J. G. Kennedy,et al.  Implementation of an open access scheduling system in a residency training program. , 2003, Family medicine.

[24]  Audrey Paulman,et al.  Why We Don’t Come: Patient Perceptions on No-Shows , 2004, The Annals of Family Medicine.

[25]  Diane H. Parente,et al.  A Pre-Post Comparison of Service Operational Efficiency and Patient Satisfaction Under Open Access Scheduling , 2005, Health Care Management Review.

[26]  S. Dixon,et al.  Evaluation of advanced access in the national primary care collaborative. , 2004, The British journal of general practice : the journal of the Royal College of General Practitioners.

[27]  E. Newman,et al.  "The rheumatologist can see you now": Successful implementation of an advanced access model in a rheumatology practice. , 2004, Arthritis and rheumatism.

[28]  Chengbin Chu,et al.  A planning and scheduling problem for an operating theatre using an open scheduling strategy , 2010, Comput. Ind. Eng..

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

[30]  Arul Earnest,et al.  Predictors of failed attendances in a multi-specialty outpatient centre using electronic databases , 2005, BMC health services research.

[31]  M. Murray,et al.  Same-day appointments: exploding the access paradigm. , 2000, Family practice management.

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

[33]  T. Bodenheimer,et al.  Improving timely access to primary care: case studies of the advanced access model. , 2003, JAMA.

[34]  D. Berwick,et al.  Advanced access: reducing waiting and delays in primary care. , 2003, JAMA.

[35]  Kurt C Stange,et al.  Continuity of Primary Care: To Whom Does It Matter and When? , 2003, The Annals of Family Medicine.

[36]  Marc Saez,et al.  Why do patients prefer hospital emergency visits? A nested multinomial logit analysis for patient‐initiated contacts , 1998, Health care management science.

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