Designing appointment system templates with operational performance targets

Abstract

We investigate characteristics of outpatient appointment templates that provide fair and controlled patient waiting experiences. Using an inverse-simulation application, we establish successive patients’ designated arrival times based on the previous patient’s finish time distribution and a universal targeted wait time set by the provider. This approach results in a template where each patient’s probability of waiting longer than a threshold duration is uniform across all patients. Through investigation of various no-show probabilities and service time distributions, we show that the template designs that achieve wait time uniformity across different patient and service environments have generalizable characteristics. Based on these characteristics, we proceed to design practitioner-oriented heuristics that create rounded interval times for implementation which yield robust performance outcomes. Results suggest that such schedules consist of appointment intervals that differ from average service times, moderated by patient show-rates and service time characteristics. In addition to introducing methods that allow patient “service level agreements,” our conclusions bring into question the advisability of double-booking, multiple-block scheduling, and yield management practices in appointment scheduling, and provide support for interval adjustment approaches that respond to patient service and no-show characteristics.