Block appointment systems for outpatient clinics with multiple doctors
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Block appointment systems for outpatient clinics with multiple doctors L Liu and X Liu The Hong Kong University of Science and Technology, Hong Kong Studies of appointment systems have to some extent led to a wide acceptance of individual or block appointment schemes in private practice and outpatient clinics. Most of the studies assume there is one punctual doctor in a clinic, which is often not the case in reality. Motivated by observations of actual clinic operations, we develop a block appointment system for clinic operations with multiple random arriving doctors. Through extensive simulation studies, we identify properties shared by the best appointment schedules. With these properties we can design a scheme based on simulation search that provides the optimal schedule for a given scheduling environment in an acceptable computation time. A simple (suboptimal) appointment rule is also proposed. Keywords: block appointment; outpatient clinics; simulation
Introduction The study of clinic patients' appointment problems date back to the 1950s (see, for example, Bailey1). These studies helped private practices and outpatient clinics to adopt individual or block appointment schemes, leading to significant improvements in their services. In the modeling and analysis of clinic operations, researchers usually need to simplify the models to make them analytically tractable. A very common assumption is that there is one punctual medical doctor (MD) in a clinic and queuing system based models can then be applied. However, this assumption is often not realistic for many outpatient clinic operations. Outpatient clinics are often served by a number of MDs who perform identical functions. This makes the outpatient clinics multi-server systems rather than singleserver systems. It has also been observed that the MDs are not always punctual. Their actual arrival times to the clinic often lag behind the scheduled time by a random time period. For many outpatient clinics, MDs cannot always arrive on time because of their commitments elsewhere, such as morning rounds at hospital inpatient wards. In this paper, we develop appointment rules for multiple MD clinics, taking into account the randomness of the MDs arrival times. We aim at developing a scheduled system which has no prior requirements in the consultation time distribution or patients' no show probability so that it can be used by various clinics with similar operational settings, as long as raw data on consultation times and doctors' arrival patterns are available.
Correspondence: Dr L Liu, Department of Industrial Engineering and Engineering Management, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
This paper is organised into six sections. The second section de®nes the problem and relates our study to the existing literature. In the third section, we ®rst analyse the problem and propose a heuristic to limit the r
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