Simulation-based evaluation of patient appointment policies for a primary care clinic with unscheduled visits: a case study

Abstract

Appointment scheduling represents an effective strategy to improve the health delivery process. The main objective of this study was to develop a framework to evaluate the impact of appointment scheduling policies on a primary care clinic with unscheduled, walk-in patient visits. A teaching hospital primary care clinic employing faculty and resident physicians was modelled and evaluated. The investigated clinic system included various types of patients, patient paths, and multiple clinic staff that served them under conditions of patient no-shows and unscheduled patient arrivals. A simulation model was developed to evaluate trade-offs in appointment scheduling policies in a primary care clinic that utilises a multi-server queueing process with stochastic arrivals and multiple processes. Recommendations for implementing walk-in policies with modifications to the appointment scheduling system were also provided.