Impact of application of queuing theory on operational efficiency of patient registration

Meeta Tyagi; P K Tyagi; Sanjeet Singh; Sidhartha Sathpathy; Sunil Kant; Shakti Kumar Gupta; Rajvir Singh

doi:10.1016/j.mjafi.2021.06.028

Impact of application of queuing theory on operational efficiency of patient registration

Med J Armed Forces India. 2023 May-Jun;79(3):300-308. doi: 10.1016/j.mjafi.2021.06.028. Epub 2021 Sep 8.

Authors

Meeta Tyagi¹, P K Tyagi², Sanjeet Singh³, Sidhartha Sathpathy⁴, Sunil Kant⁵, Shakti Kumar Gupta⁶, Rajvir Singh⁷

Affiliations

¹ Senior Consultant (Hospital Management), PMU, All India Institute of Medical Sciences, New Delhi, India.
² Associate Professor (Preventive & Social Medicine), Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India.
³ Professor, Decision Sciences Area, Indian Institute of Management, Lucknow, India.
⁴ Professor & Head (Hospital Administration), All India Institute of Medical Sciences, New Delhi, India.
⁵ MG (Med), HQ Eastern Command, India.
⁶ Medical Superintendent, Dr Rajendra Prasad Centre of Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
⁷ Chief Executive Officer, Venu Eye Institute & Research Centre, Sheikh Sarai, New Delhi, India.

Abstract

Background: Hospital administrators are often challenged with overcrowding at hospitals. The study hospital receives referred patients; however, they have to wait in long queues even for getting registered. This was a cause of concern for hospital administrators. The study was undertaken to find an amicable solution to the queues at registration using Queuing Theory.

Method: This observational and interventional study was carried out in a tertiary care ophthalmic hospital. In the first phase, data of service time and arrival rate was collected. The queuing model was built using the coefficient of variation (CoV) of the observed times. Server utilization for new patient registration was found to be 1.21 and was 0.63 for revisit patients. Scenario-based simulation carried out using free software for optimal utilization of both types of servers. Recommendations made to combine the registration process and to increase one server were implemented.In the second phase, after one year, patient registration data were collected and compared for the number of patients registered using SPSS 17.

Results: Number of patients registered within the registration timings increased whereas the number of patients registered after the registration timings decreased significantly at 95% CI with a p-value of less than 0.001. Queues finished early and more number of patients were registered in the same time.

Conclusion: Using queuing theory, the bottleneck of the systems can be identified. Scenario and software-based simulations provide solutions to the problem of queues. The study is an application of Queuing Theory with a focus on efficient resource utilization. It can be replicated in an organization with limited resources facing the challenge of queues.

Keywords: Application of queuing theory; Operational research techniques; Optimization; Resource utilization; Server utilization.