Minimizing total cost in scheduling outpatient appointments
Management Science
Queueing analysis of polling models: progress in 1990-1994
Frontiers in queueing
Simulating outpatient obstetrical clinics
Proceedings of the 31st conference on Winter simulation: Simulation---a bridge to the future - Volume 2
Modeling and analyzing a physician clinic environment using discrete-event (visual) simulation
Computers and Operations Research
Arrival first queueing networks with applications in kanban production systems
Performance Evaluation
Proceedings of the 35th conference on Winter simulation: driving innovation
Simulation Modeling and Analysis (McGraw-Hill Series in Industrial Engineering and Management)
Simulation Modeling and Analysis (McGraw-Hill Series in Industrial Engineering and Management)
A Push---Pull Network with Infinite Supply of Work
Queueing Systems: Theory and Applications
Health care logistics and space: accounting for the physical build environment
Proceedings of the Winter Simulation Conference
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Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room while patients visit for consultation, we call this the Patient-to-Doctor policy (PtD-policy). A different approach is the Doctor-to-Patient policy (DtP-policy), whereby the doctor travels between multiple consultation rooms, in which patients prepare for their consultation. In the latter approach, the doctor saves time by consulting fully prepared patients. We use a queueing theoretic and a discrete-event simulation approach to provide generic models that enable performance evaluations of the two policies for different parameter settings. These models can be used by managers of outpatient clinics to compare the two policies and choose a particular policy when redesigning the patient process. We use the models to analytically show that the DtP-policy is superior to the PtD-policy under the condition that the doctor's travel time between rooms is lower than the patient's preparation time. In addition, to calculate the required number of consultation rooms in the DtP-policy, we provide an expression for the fraction of consultations that are in immediate succession; or, in other words, the fraction of time the next patient is prepared and ready, immediately after a doctor finishes a consultation. We apply our methods for a range of distributions and parameters and to a case study in a medium-sized general hospital that inspired this research.