Improving outpatient service quality in department of orthopedic surgery by using collaborative approaches

Abstract

Nowadays, patient satisfaction is an important service quality index for many hospitals. In many Asian countries, healthcare system has a mixed-type registration which accepts for both walk-in patients and scheduled patients. It is different from western countries which accept only scheduled patients. A long waiting time (WT) of outpatient clinics is caused by this complex registration system. A survey questionnaire of patient satisfaction showed that the long waiting time is the most dissatisfied service quality for healthcare providers. This study focused on improving clinical services by using collaborative approaches to reduce outpatient waiting time for the healthcare providers. The collaborative approaches are scheduling approach with results presented in this paper and agent-based collaborative control system which is currently in progress. We collected and observed data for two months from real world situation and used data from hospital database for building and validating simulation models. Seven scheduling scenarios are performed: scenarios I adjusted proportion between walk-in patients and scheduled patients, scenario II-VI adjusted patient sequencing, and scenario VII adjusted late rate and applied a late policy for late patients. The scenario I (adjusting the proportion: 10% for walk-in patients and 90% for scheduled patients) has the highest percentage of waiting time improvement (average: 37.13 % for walk-in patients and 50.82 % for scheduled patients) compared with the other scenarios. The overall results show that adjusting proportion of patient scenario and patient sequencing scenario can improve patient waiting time in the mixed-type registration and are possible to apply to any outpatient clinics.