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Reducing Appointment Lead-Time in an Outpatient Department of Gynecology and Obstetrics Through Discrete-Event Simulation: A Case Study

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Ubiquitous Computing and Ambient Intelligence (UCAmI 2016)

Part of the book series: Lecture Notes in Computer Science ((LNISA,volume 10069))

Abstract

Appointment lead-time is a critical variable in outpatient clinic services. In Gynecology and Obstetrics departments, longer appointment lead times are associated with lower patient satisfaction, the use of more complex healthcare services, development of long-term and severe complications and the increase of fetal, infant and maternal mortality rates. This paper aims to define and evaluate improvement alternatives through the use of Discrete-event simulation (DES). First, input data analysis is performed. Second, the simulation model is created; then, performance metrics are calculated and analyzed. Finally, improvement scenarios are designed and assessed. A case study of a mixed-patient type environment (Perinatology and Gynecobstetrics) in an outpatient department has been explored to verify the effectiveness of the proposed approach. Statistical analysis evidence that appointment lead times could be significantly reduced in both Perinatology and Gynecobstetrics appointments based on the proposed approaches in this paper.

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References

  1. Wijewickrama, A.K.: Simulation analysis for reducing queues in mixed-patients’ outpatient department. Int. J. Simul. Model. 5(2), 56–68 (2006)

    Article  Google Scholar 

  2. Giachetti, R.E.: A simulation study of interventions to reduce appointment lead-time and patient no-show rate. In: 2008 Winter Simulation Conference, pp. 1463–1468. IEEE (2008)

    Google Scholar 

  3. Rohleder, T.R., Lewkonia, P., Bischak, D.P., Duffy, P., Hendijani, R.: Using simulation modeling to improve patient flow at an outpatient orthopedic clinic. Health Care Manage. Sci. 14(2), 135–145 (2011)

    Article  Google Scholar 

  4. Wijewickrama, A.A., Takakuwa, S.: Simulation analysis of an outpatient department of internal medicine in a university hospital. In: Proceedings of the 2006 Winter Simulation Conference, pp. 425–432. IEEE (2006)

    Google Scholar 

  5. Harper, P.R., Gamlin, H.M.: Reduced outpatient waiting times with improved appointment scheduling: a simulation modelling approach. OR Spectrum 25(2), 207–222 (2003)

    Article  MATH  Google Scholar 

  6. Lee, S., Min, D., Ryu, J.H., Yih, Y.: A simulation study of appointment scheduling in outpatient clinics: open access and overbooking. Simulation 89(12), 1459–1473 (2013)

    Article  Google Scholar 

  7. Chand, S., Moskowitz, H., Norris, J.B., Shade, S., Willis, D.R.: Improving patient flow at an outpatient clinic: study of sources of variability and improvement factors. Health Care Manage. Sci. 12(3), 325–340 (2009)

    Article  Google Scholar 

  8. Rohleder, T.R., Lewkonia, P., Bischak, D.P., Duffy, P., Hendijani, R.: Using simulation modeling to improve patient flow at an outpatient orthopedic clinic. Health Care Manage. Sci. 14(2), 135–145 (2011)

    Article  Google Scholar 

  9. Cao, W., Wan, Y., Tu, H., Shang, F., Liu, D., Tan, Z., Xu, Y.: A web-based appointment system to reduce waiting for outpatients: a retrospective study. BMC Health Serv. Res. 11(1), 1–5 (2011)

    Article  Google Scholar 

  10. Qu, X., Peng, Y., Kong, N., Shi, J.: A two-phase approach to scheduling multi-category outpatient appointments–a case study of a women’s clinic. Health care Manage. Sci. 16(3), 197–216 (2013)

    Article  Google Scholar 

  11. Barrios, M.A.O., Caballero, J.E., Sanchez, F.S.: A methodology for the creation of integrated service networks in outpatient internal medicine. In: Bravo, J., Hervas, R., Villarreal, V. (eds.) AmIHEALTH 2015. LNCS, vol. 9456, pp. 247–257. Springer, Heidelberg (2015). doi:10.1007/978-3-319-26508-7_24

    Chapter  Google Scholar 

  12. Barrios, M.A.O., Jimenez, H.F.: Reduction of average lead time in outpatient service of obstetrics through six sigma methodology. In: Bravo, J., Hervas, R., Villarreal, V. (eds.) AmIHEALTH 2015. LNCS, vol. 9456, pp. 293–302. Springer, Heidelberg (2015). doi:10.1007/978-3-319-26508-7_29

    Chapter  Google Scholar 

  13. Harper, P.R., Gamlin, H.M.: Reduced outpatient waiting times with improved appointment scheduling: a simulation modelling approach. OR Spectrum 25(2), 207–222 (2003)

    Article  MATH  Google Scholar 

  14. Elkhuizen, S.G., Das, S.F., Bakker, P.J.M., Hontelez, J.A.M.: Using computer simulation to reduce access time for outpatient departments. Qual. Safety Health Care 16(5), 382–386 (2007)

    Article  Google Scholar 

  15. Santibáñez, P., Chow, V.S., French, J., Puterman, M.L., Tyldesley, S.: Reducing patient wait times and improving resource utilization at British Columbia Cancer Agency’s ambulatory care unit through simulation. Health Care Manage. Sci. 12(4), 392–407 (2009)

    Article  Google Scholar 

  16. Gillespie, J., McClean, S., Garg, L., Barton, M., Scotney, B., Fullerton, K.: A multi-phase DES modelling framework for patient-centred care. J. Oper. Res. Soc. (2016)

    Google Scholar 

  17. Gijo, E.V., Antony, J.: Reducing patient waiting time in outpatient department using lean six sigma methodology. Qual. Reliab. Eng. Int. 30(8), 1481–1491 (2014)

    Article  Google Scholar 

  18. Eddy, D.M., Hollingworth, W., Caro, J.J., Tsevat, J., McDonald, K.M., Wong, J.B.: Model transparency and validation: a report of the ISPOR-SMDM modeling good research practices task force-7. Value Health 15, 843–850 (2012)

    Article  Google Scholar 

  19. McClean, S.I., Barton, M., Garg, L., Fullerton, K.: Combining Markov models and discrete event simulation to plan stroke patient care. Trans. Model. Comput. Sci. 21(4), 25 (2011)

    Google Scholar 

  20. Jun, J.B., Jacobson, S.H., Swisher, J.R.: Application of discrete-event simulation in health care clinics: a survey. J. Oper. Res. Soc. 50(2), 109–123 (1999)

    Article  MATH  Google Scholar 

  21. Herazo-Padilla, N., Montoya-Torres, J.R., Munoz-Villamizar, A., Nieto Isaza, S., Ramirez Polo, L.: Coupling ant colony optimization and discrete-event simulation to solve a stochastic location-routing problem. In: 2013 Simulations Conference (WSC), pp. 3352–3362. IEEE (2013)

    Google Scholar 

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Authors and Affiliations

  1. Department of Industrial Engineering, Universidad de la Costa CUC, Barranquilla, Colombia

    Miguel Angel Ortiz & Anyeliz Castillo

  2. School of Computing and Information Engineering, University of Ulster, Coleraine, County Londonderry, BT52 1SA, UK

    Sally McClean

  3. School of Computing and Mathematics, University of Ulster, Coleraine, UK

    Chris D. Nugent

Authors
  1. Miguel Angel Ortiz
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  2. Sally McClean
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  3. Chris D. Nugent
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  4. Anyeliz Castillo
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Corresponding author

Correspondence to Miguel Angel Ortiz .

Editor information

Editors and Affiliations

  1. University of Las Palmas de Gran Canaria, Las Palmas, Spain

    Carmelo R. García

  2. Departamento de Estadistica, Universidad La Laguna, La Laguna, Spain

    Pino Caballero-Gil

  3. Florida State University, Tallahassee, Florida, USA

    Mike Burmester

  4. University of Las Palmas de Gran Canaria, Las Palmas, Spain

    Alexis Quesada-Arencibia

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Ortiz, M.A., McClean, S., Nugent, C.D., Castillo, A. (2016). Reducing Appointment Lead-Time in an Outpatient Department of Gynecology and Obstetrics Through Discrete-Event Simulation: A Case Study. In: García, C., Caballero-Gil, P., Burmester, M., Quesada-Arencibia, A. (eds) Ubiquitous Computing and Ambient Intelligence. UCAmI 2016. Lecture Notes in Computer Science(), vol 10069. Springer, Cham. https://doi.org/10.1007/978-3-319-48746-5_28

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  • DOI: https://doi.org/10.1007/978-3-319-48746-5_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48745-8

  • Online ISBN: 978-3-319-48746-5

  • eBook Packages: Computer ScienceComputer Science (R0)

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