Matching daily healthcare provider capacity to demand in advanced access scheduling systems

Qu, Xiuli; Rardin, Ronald L.; Williams, Julie; Willis, Deanna R.

doi:10.1016/j.ejor.2006.10.003

Cited by 84 publications

(62 citation statements)

References 15 publications

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“…This includes an analytical comparison of traditional and advanced access appointment systems [23]; the impact of no-shows [5,11,12,17]; the importance of considering patient preferences [10,26]; and capacity allocation methods that allow practices to offer a blend of prescheduled (non-urgent) and same-day (urgent) appointments [2,20].…”

Section: Literature Reviewmentioning

confidence: 99%

The impact of case mix on timely access to appointments in a primary care group practice

Ozen

Balasubramanian

2012

Health Care Manag Sci

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At the heart of the practice of primary care is the concept of a physician panel. A panel refers to the set of patients for whose long term, holistic care the physician is responsible. A physician's appointment burden is determined by the size and composition of the panel. Size refers to the number of patients in the panel while composition refers to the case-mix, or the type of patients (older versus younger, healthy versus chronic patients), in the panel. In this paper, we quantify the impact of the size and case-mix on the ability of a multi-provider practice to provide adequate access to its empanelled patients. We use overflow frequency, or the probability that the demand exceeds the capacity, as a measure of access. We formulate problem of minimizing the maximum overflow for a multi-physician practice as a non-linear integer programming problem and establish structural insights that enable us to create simple yet near optimal heuristic strategies to change panels. This optimization framework helps a practice: (1) quantify the imbalances across physicians due to the variation in case mix and panel size, and the resulting effect on access; and (2) determine how panels can be altered in the least disruptive way to improve access. We illustrate our methodology using four test prac-A. Ozen

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Section: Literature Reviewmentioning

confidence: 99%

The impact of case mix on timely access to appointments in a primary care group practice

Ozen

Balasubramanian

2012

Health Care Manag Sci

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“…The multi-day focus concerns the percentage of appointment slots to reserve for open access patients [10,35,36,45,49], since this percentage influences amongst others the queue length and overtime [10]. Contrary to most available literature, Wiesche et al [49] consider flexible capacity, to cope with varying patient arrival rates during the week in a primary care clinic.…”

Section: Open Access Schedulingmentioning

confidence: 99%

“…Most open access literature consider a single-provider service system [39] with fixed deterministic appointment intervals, where the capacity for each day is fixed and known [36], and where the demand and arrival rates are given [21,35,38]. The schedules of all providers involved are often assumed to be independent, both for providers of the same patient population, as well as for up-and downstream appointments [35,36,38].…”

Section: Open Access Schedulingmentioning

confidence: 99%

Stochastic integer programming for multi-disciplinary outpatient clinic planning

Leeftink

Vliegen

Hans

2017

Health Care Manag Sci

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Scheduling appointments in a multi-disciplinary clinic is complex, since coordination between disciplines is required. The design of a blueprint schedule for a multidisciplinary clinic with open access requirements requires an integrated optimization approach, in which all appointment schedules are jointly optimized. As this currently is an open question in the literature, our research is the first to address this problem. This research is motivated by a Dutch hospital, which uses a multi-disciplinary cancer clinic to communicate the diagnosis and to explain the treatment plan to their patients. Furthermore, also regular patients are seen by the clinicians. All involved clinicians therefore require a blueprint schedule, in which multiple patient types can be scheduled. We design these blueprint schedules by optimizing the patient waiting time, clinician idle time, and clinician overtime. As scheduling decisions at multiple time intervals are involved, and patient routing is stochastic, we model this system as a stochastic integer program. The stochastic integer program is adapted for and solved with a sample Numerical experiments evaluate the performance of the sample average approximation approach. We test the suitability of the approach for the hospital's problem at hand, compare our results with the current hospital schedules, and present the associated savings. Using this approach, robust blueprint schedules can be found for a multi-disciplinary clinic of the Dutch hospital.

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“…Successful implementation of these policies requires a balance between the reserved and demanded number of slots for advanced access or walk-in patients. Too many reserved slots results in resource idle time, and too little reserved slots results in increased access time [408,409].…”

Section: Tactical Planningmentioning

confidence: 99%

“…Methods: computer simulation [498], heuristics [203], Markov processes [195,203], mathematical programming [280,408,409].…”

Section: Tactical Planningmentioning

confidence: 99%

Integrated decision making in healthcare : an operations research and management science perspective

Hulshof¹

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Matching daily healthcare provider capacity to demand in advanced access scheduling systems

Cited by 84 publications

References 15 publications

The impact of case mix on timely access to appointments in a primary care group practice

The impact of case mix on timely access to appointments in a primary care group practice

Stochastic integer programming for multi-disciplinary outpatient clinic planning

Integrated decision making in healthcare : an operations research and management science perspective

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