A two-phase approach to scheduling multi-category outpatient appointments--a case study of a women's clinic

Health Care Manag Sci. 2013 Sep;16(3):197-216. doi: 10.1007/s10729-013-9223-5. Epub 2013 Mar 14.

Abstract

In this paper, we propose a two-phase approach for designing a weekly scheduling template for outpatient clinics providing multiple types of services. In many outpatient clinics, various service types are categorized to address the operational challenge of substantial changeover time between certain pairs of services. In the first phase of our approach, a mixed-integer program is formulated to assign service categories to clinic sessions during a week and determine the optimal number of appointments reserved for each service type in each clinic session. The objective in the first phase is to balance the workload of the providers among clinic sessions. In the second phase, a stochastic mixed-integer program is formulated for each clinic session to assign each contained appointment with a starting time based on several time-based performance measures. To solve the formulated stochastic program, we develop a Monte Carlo sampling based genetic algorithm. The two-phase approach is tested numerically with cases derived from a real women's clinic. Our results demonstrate that the two-phase approach can efficiently find promising weekly appointment scheduling templates for outpatient clinics. In addition, our results suggest that the best suboptimal scheduling templates found become more sensitive to the weighting coefficients of the time-based measures as the provider workload increases.

MeSH terms

  • Algorithms
  • Ambulatory Care Facilities / organization & administration*
  • Appointments and Schedules*
  • Computer Simulation*
  • Decision Making
  • Humans
  • Monte Carlo Method
  • Operations Research*
  • Organizational Case Studies
  • Stochastic Processes
  • Time Factors
  • Workload