Simulation Based Approach for Improving Outpatient Clinic Operations

Kalwer, Muhammad Ahmed; Mari, Sonia Irshad; Memon, Muhammad Saad; Tanwari, Anweruddin; Siddiqui, Ali

doi:10.22581/muet1982.2001.15

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…Because of manual reporting in excel, a lot of time was used to be spent on the formation of reports and the purchase department used to decide for the vendors` performance. Since, cost is associated with the time (Kalwar, Khaskheli, Khan, Siddiqui, & Gopang, 2018;Kalwar, Mari, Memon, Tanwari, & Siddiqui, 2020;Khaskheli et al, 2020) and decisions were based on the report and at the same time, chance of errors in the report was greater; thus it was decided to automate the material delivery time analysis report. New method/suggested method is consisted of interface (userform) designed to execute the various macros for performing the tasks automatically in MS excel.…”

Section: Suggested Methods For Making the Reportmentioning

confidence: 99%

Optimization of material delivery time analysis by using Visual Basic for applications in Excel

Khan

Kalwar²,

Chaudhry³

2021

J APPL RES TECH ENG

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<p>In small and medium enterprises, huge numbers of reports are prepared regarding the procurement, planning, production etc on daily, weekly, monthly, quarterly and yearly basis. If the interval between preparation of same report is longer then there is the greater probability that employee can forget the procedure of preparing the report; thus it is beneficial to automate these types of reports especially when there is no cost required for automation. In the same way, material delivery analysis is a kind of report which is prepared on monthly basis and as per the employees` feedback they usually forget some of the steps of report formation; therefore, there was the chance of mistake at the end of employee. Therefore, this report was automated for to minimize the chance of error and report preparation time. All the manual tasks were enlisted and were programmed for automation by the help of VBA macros. For the execution of macros, userform was designed in visual basic editor (in MS excel) consisted on four command buttons and macros were called on command buttons` click. On pressing ‘ctrl + q’ userform used to appear on the screen. Furthermore, the comparison of old and automated methods was conducted to reflect the best suitable method. The report used to take 1.55 minutes to be made manually. Comparison of time of both methods of report formation indicated that suggested method took 70.86% less time as compared to the old method of preparing material delivery time analysis report.</p>

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Section: Suggested Methods For Making the Reportmentioning

confidence: 99%

Optimization of material delivery time analysis by using Visual Basic for applications in Excel

Khan

Kalwar²,

Chaudhry³

2021

J APPL RES TECH ENG

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“…Kritchanchai and Hoeur [ 45 ] built two DES models of old and new OPD to compare its performance and the result showed that if the healthcare changes the allocation of facilities as in the new OPD, the congestion in floor area can be reduced. Kalwar et al [ 46 ] used DES to help in finding the optimal number of doctors in OPD by applying scenario analysis. Moreover, DES can be integrated with other techniques to improve the model performance.…”

Section: Related Workmentioning

confidence: 99%

Resource management framework using simulation modeling and multi-objective optimization: a case study of a front-end department of a public hospital in Thailand

Tanantong

Pannakkong

Chemkomnerd

2022

BMC Med Inform Decis Mak

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Background The overcrowded patients, which cause the long waiting time in public hospitals, become significant problems that affect patient satisfaction toward the hospital. Particularly, the bottleneck usually happens at front-end departments (e.g., the triage and medical record department) as every patient is firstly required to visit these departments. The problem is mainly caused by ineffective resource management. In order to support decision making in the resource management at front-end departments, this paper proposes a framework using simulation and multi-objective optimization techniques considering both operating cost and patient satisfaction. Methods To develop the framework, first, the timestamp of patient arrival time at each station was collected at the triage and medical record department of Thammasat University Hospital in Thailand. A patient satisfaction assessment method was used to convert the time spend into a satisfaction score. Then, the simulation model was built from the current situation of the hospital and was applied scenario analyses for the model improvement. The models were verified and validated. The weighted max–min for fuzzy multi-objective optimization was done by minimizing the operating cost and maximizing the patient satisfaction score. The operating costs and patient satisfaction scores from various scenarios were statistically compared. Finally, a decision-making guideline was proposed to support suitable resource management at the front-end departments of the hospital. Result The three scenarios of the simulation model were built (i.e., a real situation, a one-stop service, and partially shared resources) and ensured to be verified and valid. The optimized results were compared and grouped into three situations which are (1) remain the same satisfaction score but decrease the cost (cost decreased by 2.8%) (2) remain the same satisfaction score but increase the cost (cost increased up to 80%) and (3) decrease the satisfaction score and decrease the cost (satisfaction decreased up to 82% and cost decreased up to 59%). According to the guideline, the situations 1 and 3 were recommended to use in the improvement and the situation 2 was rejected. Conclusion This research demonstrates the resource management framework for the front-end department of the hospital. The experimental results imply that the framework can be used to support the decision making in resource management and used to reduce the risk of applying a non-improvement model in a real situation.

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“…Aeenparast et al (2019) concluded that physician delay was a major factor in increased outpatient wait times in a general hospital in Iran. In a recent study in Pakistan, Kalwar et al . (2020) evaluated the wait times within a gastrology department for patients with appointments suggesting that doctors should sit in for longer hours.…”

Section: Introductionmentioning

confidence: 99%

“…Aeenparast et al, (2019) concluded that physician delay was a major factor in increased outpatient wait times in a General hospital in Iran. In a recent study in Pakistan, Kalwar et al, (2020) evaluated the wait times within a Gastronlogy department for patients with appointments suggesting that doctors should sit in for longer hours. Although these suggestions are reasonable, but not currently implementable as almost all public hospitals of developing economies are highly unorganised, overcrowded, and all patients are walk-in with variable arrival pattern.…”

Section: Introductionmentioning

confidence: 99%

An optimized queue management system to improve patient flow in the absence of appointment system

Safdar

Emrouznejad

Dey

2020

IJHCQA

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PurposeThe aim of this research study is to develop a queue assessment model to evaluate the inflow of walk-in outpatients in a busy public hospital of an emerging economy, in the absence of appointment systems, and construct a dynamic framework dedicated towards the practical implementation of the proposed model, for continuous monitoring of the queue system.Design/methodology/approachThe current study utilizes data envelopment analysis (DEA) to develop a combined queuing–DEA model as applied to evaluate the wait times of patients, within different stages of the outpatients' department at the Combined Military Hospital (CMH) in Lahore, Pakistan, over a period of seven weeks (23rd April to 28th May 2014). The number of doctors/personnel and consultation time were considered as outputs, where consultation time was the non-discretionary output. The two inputs were wait time and length of queue. Additionally, VBA programming in Excel has been utilized to develop the dynamic framework for continuous queue monitoring.FindingsThe inadequate availability of personnel was observed as the critical issue for long wait times, along with overcrowding and variable arrival pattern of walk-in patients. The DEA model displayed the “required” number of personnel, corresponding to different wait times, indicating queue build-up.Originality/valueThe current study develops a queue evaluation model for a busy outpatients' department in a public hospital, where “all” patients are walk-in and no appointment systems. This model provides vital information in the form of “required” number of personnel which allows the administrators to control the queue pre-emptively minimizing wait times, with optimal yet dynamic staff allocation. Additionally, the dynamic framework specifically targets practical implementation in resource-poor public hospitals of emerging economies for continuous queue monitoring.

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Simulation Based Approach for Improving Outpatient Clinic Operations

Cited by 10 publications

References 14 publications

Optimization of material delivery time analysis by using Visual Basic for applications in Excel

Optimization of material delivery time analysis by using Visual Basic for applications in Excel

Resource management framework using simulation modeling and multi-objective optimization: a case study of a front-end department of a public hospital in Thailand

An optimized queue management system to improve patient flow in the absence of appointment system

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