Abstract

ABSTRACTAppointment scheduling is generally applied in outpatient clinics and other healthcare services. The challenge in scheduling is to find a strategy for dealing with variability and unpredictability in service duration and patient arrivals. The consequences of an ineffective strategy include long waiting times for patients and idle time for the healthcare provider. In turn, these have implications for the perceived quality, cost‐efficiency, and capacity of healthcare services. The generation of optimal schedules is a notoriously intractable problem, and earlier attempts at designing effective strategies for appointment scheduling were based on approximation, simulation, or simplification. We propose a novel strategy for scheduling that exploits three tactical ideas to make the problem manageable. We compare the proposed strategy to other approaches, and show that it matches or outperforms competing methods in terms of flexibility, ease of use, and speed. More importantly, it outperforms competing approaches nearly uniformly in approaching the desired balance between waiting and idle times as specified in a chosen objective function. Therefore, the strategy is a good basis for further enrichments.

Highlights

  • Most healthcare services are nonprofit in nature and exist to serve their communities

  • We argue that suitable objective functions for appointment schedules in healthcare are a weighted average of idle time for the servers and waiting time for patients

  • For the sake of completeness, we include in the appendix the procedure for evaluating the objective functions introduced earlier for the case that the service– time distributions are of phase type; for more detail on how to use this type of procedures, we refer to Wang (1997) and Kuiper et al (2015)

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Summary

INTRODUCTION

Most healthcare services are nonprofit in nature and exist to serve their communities. The rising expenditures for healthcare, have created general awareness that their performance should be evaluated in terms of the delivered care relative to the expenses incurred (Porter, 2010). This in turn has drawn attention to the performance of the operating and management practices involved. One of the central challenges in healthcare-operations management is to match capacity and demand under variability and unpredictability With some exceptions such as emergent demand, healthcare services generally apply appointment scheduling to synchronize patient visits with the availability of specialists, facilities, and resources.

A FLEXIBLE AND OPTIMAL APPROACH
Preliminaries
Objective function and convexity
PROPOSED APPROACH
Phase-type approximation
Employing a precalculated grid
No-shows and walk-ins
Overtime
Possible extensions
OPERATION OF THE WEBTOOL
PERFORMANCE EVALUATION
Qualitative comparison
Quantitative comparison of performance
Findings
DISCUSSION AND CONCLUSIONS
Full Text
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