Scheduling appointments for multiple classes of patients in presence of unscheduled arrivals: Case study of a CT department

Abstract

Appointment scheduling plays a key role in improving the performance of a healthcare facility and increasing patient access to health care. However, appointment systems in hospitals may receive requests for services from walk-ins and emergency arrivals in addition to the scheduled arrivals. Emergency arrivals need urgent care, and hence have higher priority to be served over the scheduled arrivals. Such emergency arrivals disrupt the scheduled appointments, and may increase the waiting times of scheduled patients and the overtime of the appointment session. Walk-ins have lower priority to be served. However, it is desirable to serve walk-ins in order to increase the utilization of the server keeping the waiting times of scheduled patients as short as possible. In this research work, appropriate sequencing and appointment rules are identified for a computed tomography (CT) scan facility that experiences walk-in and emergency arrivals apart from regular scheduled arrivals. Several scheduling rules are evaluated under different patterns of walk-ins and emergency arrivals. In addition, the main and interaction effects of scheduling rules and arrival patterns of unscheduled patients are explored. It is found that the scheduling rules are more influential than the arrival patterns of unscheduled patients.