Appointment overbooking with different time slot structures

Abstract Unattended appointments result in underperformance of a healthcare service provider. Such uncertainty in the appointment process not only lowers healthcare utilization and productivity but also hinders patients from having timely access to healthcare services and extends waiting time for receiving medical examinations or treatments. In this study, we formulate this stochastic optimization problem for appointment scheduling as its two-stage deterministic equivalent to simultaneously optimize overbooking and scheduling decisions to compensate patient no-shows with different time slot structures. We examine the impacts of three types of time slot structures, which are of fixed-length slot intervals, dome-pattern slot intervals and flexible appointment start times, on the efficiency of the system. With the optimal solutions found, we investigate the interaction between the time slot structure and the optimal overbooking solution. We found that the flexibility in appointment start times result in a “dome-dome-dome pattern with alternate long and short time slots” and could achieve a better patient experience (regarding the patient waiting time) while maintaining the same service provider efficiency (regarding the resource overtime and idle time), compared with the pre-defined time intervals. While there has been a large body of literature on appointment scheduling, to the best of our knowledge, this “dome-dome-dome” pattern has not been reported in the existing literature. Sensitivity analysis further shows that the flexible slot scheme is more effective when the number of overbooked patients is relatively low and the service duration is relatively long.

[1]  Pei-Fang Tsai,et al.  A stochastic appointment scheduling system on multiple resources with dynamic call-in sequence and patient no-shows for an outpatient clinic , 2014, Eur. J. Oper. Res..

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

[3]  Vidyadhar G. Kulkarni,et al.  Appointment Scheduling Under Patient No-Shows and Service Interruptions , 2012, Manuf. Serv. Oper. Manag..

[4]  Ali Elkamel,et al.  Planning and Integration of Refinery and Petrochemical Operations: AL-QAHTANI:REFINERY O-BK , 2010 .

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

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

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

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

[9]  Francesco Boenzi,et al.  A simple queue model for an appointment system and applications in a hospital CT scan facility , 2014 .

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

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

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

[13]  Giovanni Mummolo,et al.  Appointment scheduling for a computed tomography facility for different patient classes using simulation , 2013 .

[14]  Kumar Muthuraman,et al.  Please Scroll down for Article Iie Transactions on Healthcare Systems Engineering Optimal and Approximate Algorithms for Sequential Clinical Scheduling with No-shows Optimal and Approximate Algorithms for Sequential Clinical Scheduling with No-shows , 2022 .

[15]  Yan Chen,et al.  Appointment Overbooking and Scheduling: Tradeoffs Between Schedule Efficiency and Timely Access to Service , 2017 .

[16]  Ana Muriel,et al.  Guidelines for scheduling in primary care under different patient types and stochastic nurse and provider service times , 2013 .

[17]  C. Rust,et al.  Patient appointment failures in pediatric resident continuity clinics. , 1995, Archives of pediatrics & adolescent medicine.

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

[19]  Chandan K. Reddy,et al.  A probabilistic model for predicting the probability of no-show in hospital appointments , 2011, Health care management science.

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

[21]  D. Sharp,et al.  Non-attendance at general practices and outpatient clinics , 2001, BMJ : British Medical Journal.

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

[23]  Ben Wang,et al.  Managing Patient Service in a Diagnostic Medical Facility , 2006, Oper. Res..

[24]  William Shonick,et al.  An Approach to Reducing the Adverse Effects of Broken Appointments in Primary Care Systems , 1977, Medical care.

[25]  Nan Liu,et al.  Panel Size and Overbooking Decisions for Appointment-Based Services under Patient No-Shows , 2014 .

[26]  Yan Chen,et al.  Using simulation to examine appointment overbooking schemes for a medical imaging center , 2015, 2015 Winter Simulation Conference (WSC).

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

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

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

[30]  Jonathan Patrick,et al.  A Markov decision model for determining optimal outpatient scheduling , 2011, Health Care Management Science.

[31]  Rainer Kolisch,et al.  Providing radiology health care services to stochastic demand of different customer classes , 2008, OR Spectr..

[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]  Amir Ahmadi-Javid,et al.  Outpatient appointment systems in healthcare: A review of optimization studies , 2017, Eur. J. Oper. Res..

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

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

[37]  Alexander Shapiro,et al.  The Sample Average Approximation Method for Stochastic Discrete Optimization , 2002, SIAM J. Optim..

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

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

[40]  Nan Liu,et al.  Appointment Scheduling Under Patient Preference and No-Show Behavior , 2014, Oper. Res..

[41]  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.

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

[43]  Nan Liu.  Optimal choice for appointment scheduling window under patient no-show behavior , 2016 .

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

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

[46]  Kum Khiong Yang,et al.  A Universal Appointment Rule with Patient Classification for Service Times, No-Shows, and Walk-Ins , 2014 .

[47]  Brian T. Denton,et al.  Dynamic Appointment Scheduling of a Stochastic Server with Uncertain Demand , 2013, INFORMS J. Comput..