An optimization model to determine appointment scheduling window for an outpatient clinic with patient no-shows
- 526 Downloads
This paper investigates appointment scheduling for an outpatient department in West China Hospital (WCH), one of the largest single point of access hospitals in the world. Our pilot data analysis shows that the appointment system at WCH can be improved through leveraging the scheduling window (i.e., the number of days in advance a patient makes an appointment for future services). To gain full insight into this strategy, our study considers two cases, based on if patients are willing to wait for scheduled appointments or not. We developed a stylized single server queueing model to find optimal scheduling windows. Results show that, when patients are less sensitive to time delay (i.e., patients will wait for scheduled services), levering scheduling windows is not effective to minimize the total cost per day of the appointment system. In contrast, when patients are sensitive to time delay (i.e., patients may find services elsewhere), then our model considers the potential cost of physician idle time. The modeling results indicate that the total cost per day is relatively sensitive to the magnitude of scheduling window. Thus, adopting a proper scheduling window is very important. In addition, our study proves that the cost functions of both cases are quasi-concave, which are also validated by actual data drawn from the Healthcare Information System at WCH. A comparison of numerical results between two cases is made to draw further managerial insights into scheduling policies for WCH. Discussion of our findings and research limitations are also provided.
KeywordsScheduling window Outpatient appointment Patient no-shows Queueing theory Healthcare management
This project was sponsored by the Nature Science Foundation of China (71532007, 71131006, 71172197 and 70771068), Central University Fund of Sichuan University Number skgt201202 and Science and Technology Department Project of Sichuan Province (2015ZR0097). The authors gratefully acknowledged the support from the department of operations management in West China Hospital.
Compliance with ethical standards
Conflict of interest
- 1.Garza A (2016) The aging population: The increasing effects on health care. Pharm Times. http://www.pharmacytimes.com/publications/issue/2016/january2016/the-aging-population-the-increasing-effects-on-health-care. Accessed 31 July 2016
- 2.Chang J, Wood D, Jia X, Gifford B (2008) Emerging trends in Chinese healthcare: the impact of a rising middle class. J Int Hospital Federation 44(4):11–20Google Scholar
- 3.Eggleston K (2012) Health care for 1.3 billion: An overview of China’s health system. Asia Health Policy Program, working paper series on health and demographic change in the Asia-Pacific, paper # 28, Stanford UniversityGoogle Scholar
- 4.Brandenburg L, Gabow P, Steele G, Toussaint J, Tyson BJ (2015) Innovation and best practices in health care scheduling. IOM, NAM Web. https://nam.edu/perspectives-2015-innovation-and-best-practices-in-health-carescheduling/. Accessed 25 Aug 2016
- 5.World Health Organization (2015) WHO global strategy on people-centered and integrated health services. http://www.who.int/servicedeliverysafety/areas/people-centred-care/global-strategy/en/. Accessed 25 Aug 2016
- 12.Bailey NTJ (1952) A study of queues and appointment systems in hospital out-patient departments, with special reference to waiting-times. J R Stat Soc Ser B Methodol 14(2):185–199Google Scholar
- 21.Nguyen TBT, Sivakumar AI, Graves SC (2016) Scheduling rules to achieve lead-time targets in outpatient appointment systems. Health Care Manag Sci. https://doi.org/10.1007/s10729-016-9374-2