Appl Clin Inform 2015; 06(02): 271-287
DOI: 10.4338/ACI-2014-10-RA-0094
Research Article
Schattauer GmbH

Appointment Template Redesign in a Women’s Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency

Y. Huang
1   Department of Industrial Engineering, New Mexico State University, Las Cruces, NM, USA
,
S. Verduzco
1   Department of Industrial Engineering, New Mexico State University, Las Cruces, NM, USA
› Author Affiliations
Further Information

Publication History

received: 23 October 2014

accepted: 01 March 2015

Publication Date:
19 December 2017 (online)

Summary

Background: Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability.

Objectives: This study was conducted in a Women’s Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints.

Methods: The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The reclassification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type.

Results: The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients.

Conclusions: This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate.

Citation: Huang Y, Verduzco S. Appointment Template Redesign in a Women’s Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency. Appl Clin Inf 2015; 6: 271–287

http://dx.doi.org/10.4338/ACI-2014-10-RA-0094