Assuring Access to Care Under Health Reform: The Key Role of Workforce Policy

Examines policy and practical options for addressing the projected shortage of primary care physicians to ensure access to health care under expanded insurance coverage, including reorganizing practices to make productive use of nurses and other staff

An evaluation of an appointment scheduling system in an ophthalmology clinic

Appointment scheduling systems are often not appropriate based on the patient population’s needs and the nature of the medical specialty. Timeliness, access, and efficiency are compromised if a health system’s scheduling model is not well-suited for its environment. These compromises can be detrimental to the health of patients, the workload burden on providers, and the financial viability of health systems. An outpatient ophthalmology clinic was evaluated and proved to have a scheduling model that was causing a number of concerns. Accounting for the nature of the medical specialty, the variation in appointment lengths, and the needs of patients, a hybrid scheduling model with carve-out access accompanied by an electronic health record timing data is more appropriate for the outpatient ophthalmology clinic

Examining The Influence Of Dependent Demand Arrivals On Patient Scheduling

This research examines the influence of batch appointments on patient scheduling systems. Batch appointments are characterized by multiple patients within a family desiring appointments within the same time frame

Taxonomic classification of planning decisions in health care: a review of the state of the art in OR/MS

We provide a structured overview of the typical decisions to be made in resource capacity planning and control in health care, and a review of relevant OR/MS articles for each planning decision. The contribution of this paper is twofold. First, to position the planning decisions, a taxonomy is presented. This taxonomy provides health care managers and OR/MS researchers with a method to identify, break down and classify planning and control decisions. Second, following the taxonomy, for six health care services, we provide an exhaustive specification of planning and control decisions in resource capacity planning and control. For each planning and control decision, we structurally review the key OR/MS articles and the OR/MS methods and techniques that are applied in the literature to support decision making

Simulation Model to Study Provider Capacity Release Schedules under Time-Varying Demand Rate for Acute Appointments, Demand for Follow-Up Appointments, and Time-Dependent No Show Rate

We address the problem of scheduling patient appointments in a family medicine clinic. A significant barrier to a clinic’s sustainability is under-utilization of the medical providers it employs. Practically all patient appointments are scheduled some time in advance (from an hour to months ahead), and under-utilization happens because some patients do not keep their appointments and do not provide sufficient notice for the clinic to reschedule another patient into the freed slot. Using a stylized simulation model we investigate an algorithm for appointment capacity release that increases provider utilization

Patient-Centered Appointment Scheduling Using Agent-Based Simulation

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling

Re-engineering the outpatient process flow of a multi-speciality hospital

Manufacturing concepts such as Just-in-Time, Lean and Six-Sigma, Japanese 5S, Materials Requirement Planning, Scheduling and Capacity Management have been applied in the Healthcare industries in the West for the last decade and has yielded positive results. In this study, these concepts and philosophies have been applied to an Indian Multi-speciality Hospital to improve its OPD process flow and increase patient satisfaction. The Outpatients Department (OPD) is usually the most crowded sector in a hospital. The frequent problems encountered include the waiting period for consultation, an unpredictable number of Walk-in patients, insufficient and operationally deficient OPD reception staff and unattended appointment patients. This study aims at, identifying methods to standardise OPD operations management. It has made the process more efficient through optimum resource utilisation. This will increase patient satisfaction by meeting and exceeding their expectations while maintaining quality of care. This research was conducted by mapping the process flow and using the data that was collected through an observational, cross-sectional, non-interventional study. Though there were a comprehensive set of recommendations at the end of the study, only a few could be implemented due to the introduction of a new Hospital Information System (HIS) software putting the implementation plan on hold

Designing of elements for Digitized Referral Appointment System (DRAS) towards enhancing booking appointments in Tanzania

The issue of making an appointment with accessing referral services, you need to have individual relationships to the medical staffs like friendship or relatively. In Tanzania, many years ago, the tradition referral systems did not offer assurance to access specialty hospital services. Numbers of ICT projects have been adopted and put into application but referral area remains forgotten. The challenges to referral services include shortage of human resources, facilities and equipment. Tanzania has several regional hospitals with a few medical doctors who are not specialized in referral services. No way, patient has to travel from one hospital to another seeking for quality healthcare delivery by faith without assurance of being served. Thus, create long waiting time for patients, doctors’ idle time, unnecessary cost to patients and disturbances. The major purpose of this paper is to design detailed elements of Digitized Referral Appointment System (DRAS) through application of ICT to solve referral challenges by allowing patients to book an appointment to access referral services before travelling. This solution will provide efficient use of few available health resources like medical specialty doctors, time and equipments. Keywords: Referral services, Patient appointment system/Technology (PAS/T), Information and Communication Technology (ICT), Digitized Referral Appointment System (DRAS) and E-healthcare.