Research Reports from the Department of Operations
Document Type
Dissertation
Publication Date
1-1-1976
Abstract
This dissertation is concerned with models for booking patient-visits to physicians in the various departments of an outpatient clinic. A major outpatient clinic is used as the institutional basis for this study. A general description of the operations of the particular clinic is presented. A review of the literature is made. It is noted that most of the research for medical clinics is oriented towards minimizing both the physicians' idle time and the patients' waiting time. Similarities between the booking of passengers to airplane seats and patients to doctors are presented. Certain appointment types may generate appointment requests for the same and/or other doctors. To efficiently explore this phenomenon, a new appointment classification is proposed. In order to have a means of measuring effectiveness of different booking policies each appointment request is assigned to one of three levels of urgency. These are in turn based on physician determined criteria. The booking problem is then formulated as a finite-state finite-decision Markov decision process. Due to the dimensionality problems in computation, it is collapsed to more constrained but still meaningful models. Two of these collapsed models, both considering one doctor at a time, are analyzed in great detail. One of the models studied considers the problem of booking each appointment type separately. A booking procedure based on the concept of a better starting state for a Markov decision process is developed. The other model studied considers the problem of simultaneous booking for all appointment types. A simulation version of this model is presented. From the booking procedure developed for the first model, enough information can be drawn to a class of booking policies that would work well in more complete models. Some policies belonging to this class as well as the booking policy currently followed by the clinic used as the basis for this study are tested through the simulation model. Data obtained at the Clinic are used. The potential uses of the simulation model as a planning tool in an outpatient clinic are discussed.
Keywords
Operations research, Ambulatory medical care--Decision making, Ambulatory medical care--Case studies, Hospitals--Outpatient services--Evaluation, Markov processes, Decision making--Mathematical models, Medical appointments and schedules, Medical care--Simulation methods
Publication Title
Dissertation/Technical Memorandums from the Department of Operations, School of Management, Case Western Reserve University
Issue
Technical memorandum no. 367 ; Submitted in partial fulfillment of the requirements for the Degree of Doctor of Philosophy
Rights
This work is in the public domain and may be freely downloaded for personal or academic use
Recommended Citation
Mello da Silva, Joao, "Booking Policies for Outpatient Clinics" (1976). Research Reports from the Department of Operations. 61.
https://commons.case.edu/wsom-ops-reports/61