Journal ArticleDOI
Reserving Capacity for Urgent Patients in Primary Care
TLDR
The importance of patient arrival dynamics to their relative performance is demonstrated, finding that encouraging routine patients to call for same-day appointments is a key ingredient for the success of advanced-access.Abstract:
This paper examines the effect of the common practice of reserving slots for urgent patients in a primary health care practice on two service quality measures: the average number of urgent patients that are not handled during normal hours (either handled as overtime, referred to other physicians, or referred to the emergency room) and the average queue of non-urgent or routine patients. We formulate a stochastic model of appointment scheduling in a primary care practice. We conduct numerical experiments to optimize the performance of this system accounting for revenue and these two service quality measures as a function of the number of reserved slots for urgent patients. We compare traditional methods with the advanced-access system advocated by some physicians, in which urgent slots are not reserved, and evaluate the conditions under which alternative appointment scheduling mechanisms are optimal. Finally, we demonstrate the importance of patient arrival dynamics to their relative performance finding that encouraging routine patients to call for same-day appointments is a key ingredient for the success of advanced-access.read more
Citations
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Journal ArticleDOI
Taxonomic classification of planning decisions in health care: a structured review of the state of the art in OR/MS
Peter J. H. Hulshof,Nikky Kortbeek,Nikky Kortbeek,Richard J. Boucherie,Erwin W. Hans,Piet J. M. Bakker +5 more
TL;DR: A comprehensive overview of the typical decisions to be made in resource capacity planning and control in health care, and a structured review of relevant articles from the field of Operations Research and Management Sciences (OR/MS) for each planning decision.
Journal ArticleDOI
Outpatient appointment systems in healthcare: A review of optimization studies
TL;DR: This paper provides a comprehensive review of recent analytical and numerical optimization studies that present decision-support tools for designing and planning outpatient appointment systems (OAS) and provides a structure for organizing the recent literature according to various criteria.
Journal ArticleDOI
A Comparison of Traditional and Open-Access Policies for Appointment Scheduling
TL;DR: This paper compares two types of appointment-scheduling policies for single providers: traditional and open-access, and finds that the open- access schedule will significantly outperform the traditional schedule, except when patient waiting time is held in little regard or when the probability of no-shows is quite small.
Journal ArticleDOI
Design and Analysis of Hospital Admission Control for Operational Effectiveness
TL;DR: This work describes an optimal admission threshold policy using controls on the scheduled and expedited gateways for a new Markov decision process model and presents a practical policy based on insight from the analytical model that yields reduced emergency blockages, cancelations, and off-unit census via simulation based on historical hospital data.
Journal ArticleDOI
Optimal Advance Scheduling
TL;DR: This work considers a canonical model of dynamic advance scheduling with two patient classes: an urgent demand class which must be served on the day of arrival, and a regular demand class, which can be served at a future date.
References
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Journal ArticleDOI
Crossing the Quality Chasm: A New Health System for the 21st Century
TL;DR: Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Journal ArticleDOI
Appointment scheduling in health care: Challenges and opportunities
Diwakar Gupta,Brian T. Denton +1 more
TL;DR: A road map of the state of the art in the design of appointment management systems is provided and future opportunities for novel applications of IE/OR models are identified.
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