A simulation study of outpatient scheduling with multiple providers and a single device

Effective outpatient appointment scheduling aims at reducing patient waiting time and operational costs, and improving resource utilization, especially given the stochastic nature of patient arrivals. Unlike many western developed countries, China faces challenges due to imperfect appointment systems and ineffective resource allocation. Those challenges lead to long patient waiting times and significant pressure to provide accurate and reliable medical diagnosis that can handle the increasing demand for patient care. In this paper, an outpatient appointment scheduling model for primary care settings was developed. The model was structured for a multi-provider clinic with a single medical device that allows for revisit (i.e., follow-up) procedures. A total of six scheduling rules were designed and tested. Then, sensitivity analysis was performed with respect to two parameters: the percentage of patients with fixed appointments and walk-ins, and the scheduled physician assessment times. The experimental results of the simulation model were used to determine the optimal values for the two parameters. Among the six scheduling rules tested, the one that involves patients with fixed appointments and walk-ins to be served alternatively every hour, led to the shortest waiting time and the highest equipment and staff utilization. In this scenario, patients with fixed appointments are served by Provider 1, while walk-ins are served by Providers 2 and 3. The sensitivity analysis under this rule revealed that when the percentage of patients with fixed appointments and walk-ins was 30-70%, and the scheduled service time was 20 minutes, the total patient waiting time and total resource idle time were minimized.