Outpatient clinics
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Outpatient clinics The CLINSIM simulation package Ray Paul Hospital out-patient clinics are a typical example of
the sorts of problems that simulation modelling should be able to handle. In this paper a visual simulation modelling approach to this problem is examined using the simulation package SIMSCRIPT 11.5.
National Health Service in the United Kingdom recognises this as a recurring problem which has
many political undertones (Thakar and Malin, 1989).
It is the sort of problem that is likely to generate questions by Members of Parliament in the House of
Commons, and then to generate questions by the Minister concerned from his civil servants.
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Visual simulation has made it possible to show interested parties in hospital outpatient clinics how
the clinic appointment and operating policy can influence patient waiting time. A computer based visual simulation model was built, made up of a complex data input component to define the clinic logistics, and an iconic visual simulation representation to show the effect of the policy. The package was built using a simulation package for the simula-
It is curious that this problem has existed for so long, given that there have been many attempts at trying to solve it, and fairly well known theories as to how the problem can be solved. The attempts that have been made to solve this problem have made use of queueing theory, simulation modelling of a blackbox type, statistical analysis, and there have been many investigative studies of a general nature which by and large led to the same conclusions. The conclusions which can be generated by these mathemati-
tion component. Some success concerning the
cal techniques or common sense are, that if one assumes that doctors' time is more important than
some problems. The simulation model has been
patient waiting times, then clinics will be loaded with patients to make sure that doctors do not wait. The second confounding factor is the assumption made in making these appointment schedules, that doctors will arrive on time in the clinic, and this historically has not been proved to be true. This combination of factors, overloading the clinic at the beginning of the clinic session and the irregular arrival times of doctors, in effect causes the problem considered here.
package based approach is reported on, as well as
evaluated in a number of test clinics. Visual simula-
tion can show how patient waiting times can be
reduced, thereby forming the basis for discussions on outpatient clinic appointment and operating practice. A similar approach may be beneficial to other organisational aspects of health care. We first look at the background to the problem which
required the development of a visual simulation modelling package called CLINSIM. The following section describes the features of the CLINSIM package that were required by the customer for the
system. The final section discusses the future of CLINSIM and the more widespread use of such systems in medicine.
CLINSIM's background
lt has long been recognise
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