scholarly journals Sequential Appointment Scheduling Considering Walk-In Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Chongjun Yan ◽  
Jiafu Tang ◽  
Bowen Jiang
Keyword(s):  
Objective Function ◽  
Waiting Time ◽  
Service Time ◽  
Appointment Scheduling ◽  
Optimal Scheduling ◽  
Sufficient Condition ◽  
Profit Function ◽  
Number Of Patients ◽  
Service Efficiency ◽  
Appointment Time

This paper develops a sequential appointment algorithm considering walk-in patients. In practice, the scheduler assigns an appointment time for each call-in patient before the call ends, and the appointment time cannot be changed once it is set. Each patient has a certain probability of being a no-show patient on the day of appointment. The objective is to determine the optimal booking number of patients and the optimal scheduling time for each patient to maximize the revenue of all the arriving patients minus the expenses of waiting time and overtime. Based on the assumption that the service time is exponentially distributed, this paper proves that the objective function is convex. A sufficient condition under which the profit function is unimodal is provided. The numerical results indicate that the proposed algorithm outperforms all the commonly used heuristics, lowering the instances of no-shows, and walk-in patients can improve the service efficiency and bring more profits to the clinic. It is also noted that the potential appointment is an effective alternative to mitigate no-show phenomenon.

scholarly journals SIMULASI ANTRIAN UNTUK APPOINTMENT SCHEDULING PADA SISTEM PELAYANANKESEHATAN (STUDI KASUS POLIKLINIK PENYAKIT DALAM)

2017 ◽  
Vol 5 (1) ◽  
pp. 49
Author(s):  
Diyah Pramita Sari ◽  
Anna Maria Sri Asih
Keyword(s):  
Internal Medicine ◽  
Waiting Time ◽  
Service Time ◽  
Large Scale ◽  
Appointment Scheduling ◽  
Health Institution ◽  
Long Time ◽  
Study Case

Hospital as a health institution must be able to give good services for its stakeholders, especially patients. However, patients often have to wait for quite a long time in queues before service. A study case in an internal medicine polyclinic in a large scale hospital in Yogyakartashowed that for around 60 patients in a day, they have to stay in queues for more than one hour averagely. This observation occurred when appointment scheduling was used, i.e. patient must make an appointment for the service time. This research evaluated some scenarios that can reduce the waiting time in this system. Results showed that patient’s arrival was recommended to be schedulled every 15 minutes with adjustment on the number of operating server. This recommendation can reduce patient’s waiting time by 28-50% by taking into account the presence of the late doctors.

Some comparability results for waiting times in single- and many-server queues

1984 ◽  
Vol 21 (4) ◽  
pp. 887-900 ◽  
Author(s):  
D. J. Daley ◽  
T. Rolski
Keyword(s):  
Waiting Time ◽  
Service Time ◽  
Waiting Times ◽  
Queueing Systems ◽  
Random Variables ◽  
Interarrival Time ◽  
Sufficient Condition ◽  
Traffic Intensity ◽  
Many Server Queues ◽  
Stationary Waiting Time

It is shown that the stationary waiting time random variables W′, W″ of two M/G/l queueing systems for which the corresponding service time random variables satisfy E(S′−x)+ ≦ E(S″−x)+ (all x >0), are stochastically ordered as W′≦dW″. The weaker conclusion, that E(W′−x)+ ≦ E(W″−x)+ (all x > 0), is shown to hold in GI/M/k systems when the interarrival time random variables satisfy E(x−T′)+ ≦ E(x−T″)+ (all x). A sufficient condition for wk≡EW in GI/D/k to be monotonic in k for a sequence of k-server queues with the same relative traffic intensity is given. Evidence indicating or refuting possible strengthenings of some of the results is indicated.

Some comparability results for waiting times in single- and many-server queues

1984 ◽  
Vol 21 (04) ◽  
pp. 887-900 ◽  
Author(s):  
D. J. Daley ◽  
T. Rolski
Keyword(s):  
Waiting Time ◽  
Service Time ◽  
Waiting Times ◽  
Queueing Systems ◽  
Random Variables ◽  
Interarrival Time ◽  
Sufficient Condition ◽  
Traffic Intensity ◽  
Many Server Queues ◽  
Stationary Waiting Time

It is shown that the stationary waiting time random variables W′, W″ of two M/G/l queueing systems for which the corresponding service time random variables satisfy E(S ′−x)+ ≦ E(S ″−x)+ (all x >0), are stochastically ordered as W ′≦d W ″. The weaker conclusion, that E(W ′−x)+ ≦ E(W ″−x)+ (all x > 0), is shown to hold in GI/M/k systems when the interarrival time random variables satisfy E(x−T ′)+ ≦ E(x−T ″)+ (all x). A sufficient condition for wk ≡EW in GI/D/k to be monotonic in k for a sequence of k-server queues with the same relative traffic intensity is given. Evidence indicating or refuting possible strengthenings of some of the results is indicated.

493 Evaluation of Patient Waiting Times for Plain Radiographs Whilst Attending Outpatient Clinics in A Tertiary Orthopaedic Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hayat ◽  
E Kinene ◽  
S Molloy
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Time Frame ◽  
Outpatient Clinics ◽  
Contributing Factors ◽  
Time Data ◽  
Work Related ◽  
Mean Waiting Time ◽  
Appointment Time ◽  
Related Stress

Abstract Introduction Reduction of waiting times is key to delivering high quality, efficient health care. Delays experienced by patients requiring radiographs in orthopaedic outpatient clinics are well recognised. Method To establish current patient and staff satisfaction, questionnaires were circulated over a two-week period. Waiting time data was retrospectively collected including appointment time, arrival time and the time at which radiographs were taken. Results 84% (n = 16) of radiographers believed patients would be dissatisfied. However, of the 296 patients questioned, 56% (n = 165) were satisfied. Most patients (89%) felt the waiting time should be under 30 minutes. Only 36% were seen in this time frame. There was moderate negative correlation (R=-0.5); higher waiting times led to increased dissatisfaction. Mean waiting time was 00:37 and the maximum 02:48. Key contributing factors included volume of patients, staff shortages (73.7%), equipment shortages (57.9%) and incorrectly filled request forms. Eight (42.1%) had felt unwell from work related stress. Conclusions A concerted effort is needed to improve staff and patient opinion. There is scope for change post COVID. Additional training and exploring ways to avoid overburdening the department would benefit. Numerous patients were open to different days or alternative sites. Funding requirements make updating equipment, expanding the department and recruiting more staff challenging.

HOW TO REPORT AND MONITOR THE PERFORMANCE OF WAITING LIST MANAGEMENT

2002 ◽  
Vol 18 (3) ◽  
pp. 611-618
Author(s):  
Markus Torkki ◽  
Miika Linna ◽  
Seppo Seitsalo ◽  
Pekka Paavolainen
Keyword(s):  
Hallux Valgus ◽  
Waiting Time ◽  
Varicose Vein ◽  
Elective Surgery ◽  
Waiting Times ◽  
Waiting List ◽  
Mean Waiting Time ◽  
Number Of Patients ◽  
Potential Problems ◽  
Queue Discipline

Objectives: Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management. Methods: There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in—first out) and another a poor queue discipline (random) queue. Results: There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations. Conclusions: A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.

scholarly journals Pilot Study on Frailty and Functionality on Routine Clinical Assessment in Allogeneichematopoietic Cell Transplantation to Predict Outcomes

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 380-380 ◽  
Author(s):  
Maria Queralt Salas ◽  
Eshetu G Atenafu ◽  
Ora Bascom ◽  
Leeann Wilson ◽  
Arjun Law ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pilot Study ◽  
Stem Cell Transplantation ◽  
Grip Strength ◽  
Cell Transplantation ◽  
Waiting Time ◽  
Acute Gvhd ◽  
Number Of Patients ◽  
And Function

Introduction: Frailty can adversely affect the outcomes of allogeneic hematopoietic stem cell transplantation (alloHSCT) but is difficult to measure in busy transplant clinics. The limited published studies have used dedicated trained persons and comprehensive geriatric assessment (GA) tools, which are time consuming (Muffly LS, Haematologica 2014; Holmes HM, J Geriatr Oncol 2014; Rodrigues M, J Geriatr Oncol 2019). The difficulty in application of GA tools by transplant clinicians, residents and nurses in their clinics has resulted in low adoption rates in routine practice. At our center we adopted selected tests for frailty and function which could be conducted during pre-transplant consultation in a busy clinic, without extra waiting time for patients, and using existing staff. The Timed up and Go test (TUGT) was adopted as it could be done in any closed clinic room, without need for a corridor. Thus it was considered safer than a gait speed test and was even applicable to patients in "isolation". We aim to share a preliminary analysis of the applicability and correlation between our selected frailty assessment with transplant outcomes and complications. Methods: Patients referred for transplant underwent the following assessments conducted by different providers. All ages were included. Relevant tests and source of data are as follows: Frailty and function by clinician evaluating (a) Clinical Frailty scale (CFS) with 9 points based on clinical judgement (Rockwood 2005) (b) Lawton's Instrumental activities of daily living (IADL). Objective physical performance by nursing BMT coordinator using (a) TUGT and (b) Grip strength using hydraulic "Jamar" hand dynamometer conducted in clinic room at time of documentation. Self assessment by patient completing (a) Self-rated health (SRH) question and (b) a question on falls. Blood tests (a) CRP (b) Albumin. The present study is a single center prospective observational study. Patients who did not proceed to transplant were excluded. Ninety-six consecutive adult allo-HSCT patients were eligible for the present analysis, updated on July 2019. The parameters were individually correlated with overall survival (OS), non-relapse mortality (NRM), cumulative incidence (cum.Inc) of acute GVHD, median time of transplant hospitalization and readmissions. Multivariate analysis was not performed in this pilot study due to limited number of patients and low frequency of adverse events. Results: Baseline characteristics and main post-transplant information are noted in Table 1. Median follow up of cohort was 5 months. Table 2 shows the main outcomes (with normal values). For the entire cohort the median OS at 6 months was 73.9% (range 61.7-82.8), NRM at day+100 was 8.7% (range 2.6-14.7), Cum.Inc of Acute GVHD 41.1% (range 30.1-52.1), Cum.Inc gr II-IV acute GVHD was 25.7% (range 15.6-35.9). Relapse occurred in 8 cases (8.3%) and deaths in 23 (23.9%). A TUGT of more than 10 seconds and raised CRP predicted poor OS (p<0.05). Abnormal TUGT, SRH question score of <A (excellent), lower albumin levels and raised CRP levels correlated with high NRM (p<0.05). A Clinical Frailty Score of more than 2, limitations of 1 or more IADLs, Grip strength below normal for age and sex, TUGT >10 seconds, SRH question <A, and lower albumin level were significant predictors for a longer median duration of transplant hospitalization. No frailty or functionality parameter correlated significantly with the Cum.Inc of any grade of acute GVHD, grade II-IV acute GVHD or the risk of rehospitalization after alloHSCT. Conclusions: Our pilot study shows that with selected brief tools, frailty and functionality can be assessed as part of routine clinical practice in allogeneic-stem cell transplantation in all age groups without extra waiting time for patients or additional human resources. TUGT is a useful prognostic tool which can be conducted in a clinic room and correlates with OS, NRM, and duration of hospitalization. Larger number of patients and longer follow-up will help to evaluate the different assessment modalities as prognostic tools in allo-HSCT and their wider applicability. Disclosures Michelis: CSL Behring: Other: Financial Support. Mattsson:Gilead: Honoraria; Celgene: Honoraria; Therakos: Honoraria.

scholarly journals Analysis of queue change of visitors and performace system in the Department of Population and Civil Regristation of Semarang City

2020 ◽  
Vol 202 ◽  
pp. 15005
Author(s):  
Sugito ◽  
Alan Prahutama ◽  
Dwi Ispriyanti ◽  
Mustafid
Keyword(s):  
Customer Satisfaction ◽  
Waiting Time ◽  
Public Service ◽  
Service Time ◽  
Service Sector ◽  
General Distribution ◽  
Queuing Systems ◽  
Queuing Model ◽  
The Public ◽  
Second Period

The Population and Civil Registry Office in Semarang city is one of the public service units. In the public service sector, visitor / customer satisfaction is very important. It can be identified by the length of the queue, the longer visitors queue this results in visitor dissatisfaction with the service. Queue analysis is one of the methods in statistics to determine the distribution of queuing systems that occur within a system. In this study, a queuing analysis as divided into two periods. The first period lasts from 2-13 March 2015, while the second period lasts November 16th to December 20th 2019. The variables used are the number of visitors and the service time at each counter in intervals of 30 minutes. The results obtained are changes in the distribution and queuing model that is at counter 5/6 and counter 10. The queuing model obtained at the second perideo for the number of visitors and the time of service with a General distribution. The average number of visitors who come in 30 minute intervals in the second period is more than the first period, this indicates an increase in visitors. The opportunity for service units is still small, the waiting time in the queue is getting smaller. This shows that the performance of the queuing system at the Semarang Population and Civil Registry Office is getting better.

scholarly journals Assessing DNA rates within first time psychiatric referrals and the extent to which DNA rates are reduced by an SMS reminder service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S315-S315
Author(s):  
Henry Coates
Keyword(s):  
Data Collection ◽  
Waiting Time ◽  
Text Messaging ◽  
Positive Impact ◽  
Waiting Times ◽  
National Guidelines ◽  
Medical Specialties ◽  
Number Of Patients ◽  
First Time ◽  
Communication Preference

Aims1) To assess the average wait time for patients to be offered an appointment and to establish any correlations between longer waiting times and 'Did not attend (DNA)' rates 2) To assess the number of patients who have opted into the text message appointment reminder service and whether this had an effect on DNA rates.BackgroundResearch has indicated that the Did Not Attend (DNA) rate in Psychiatry is estimated at 20%, twice that of other medical specialties (1). With NHS Digital estimating that DNAs cost the NHS £1 Billion per annum, there has been much interest in reducing the rate of DNAs within Psychiatry (2). Findings have shown that short waiting times are associated with higher rates of attendance (3). In addition, poor appointment attendance within Psychiatry is also associated with increased disease severity and higher rates of hospital admission (4).MethodWe conducted retrospective data collection on 99 patients referred to Professor Oyebode between January 2018 and August 2019. Our data collection involved assessing time the referral was received, time to first appointment and the patient's communication preference (e.g. whether they opted in to the SMS alert service). All data collection was conducted through use of RIO and coded/ammonized into a Excel spreadsheet. No sampling methods were employed and our population only consisted of first-time referrals to Professor Oyebodes clinic.Result1) We found no correlation between a longer waiting time to first appointment and an increased DNA rate.2) All patient waiting times between 1st January - 31st August were within the maximum limit set by national guidelines3) Opting into the text messaging service remains severely low. Of the patients audited, 95% had not completed a communication preference form. Overall, it is still unclear whether the text messaging service has a positive impact on DNA rates.ConclusionOur data have shown no significant correlation between a longer waiting time and an increased DNA rate for first time Psychiatry appointments. Secondly, we have concluded that between the audited period, waiting times were still within the maximum 18 week wait set by the Mental Health Standards. Finally, we can conclude that uptake of the text messaging service remains very low at 4%. Due to a limited sample size of only 4 patients, it is still unclear from this audit whether opting into the text messaging services will have a positive decrease on the number of DNA's.

scholarly journals Appointment scheduling system in multi doctor/multi services environment

2021 ◽  
Vol 12 (3) ◽  
pp. 171-176
Author(s):  
Ivica Lukić ◽  
Mirko Köhler ◽  
Erik Kiralj
Keyword(s):  
Health Care Providers ◽  
Web Application ◽  
Appointment Scheduling ◽  
Care Providers ◽  
Medical Providers ◽  
Health Tourism ◽  
Specific Service ◽  
Appointment Time ◽  
Patient Waiting Time ◽  
Improve Health

Appointment scheduling systems are used by health care providers to manage access to their services. In this paper an algorithm and a web application for automatic appointment scheduling is presented. Both are implemented using the concept of booking appointments for patients for a specific service offered by each doctor. The purpose of the application is to make signing up for a specific service easier for patients and to improve health tourism in Croatia by maximizing doctor’s efficiency and minimize patient waiting time. Medical providers are added to the system, they add the services which they provide, and each service offered has its own duration time. Users register, search for services matching their parameters, and schedule an appointment for the requested service. Available appointments are generated using the presented algorithm, which is the main part of this paper. The algorithm searches the database and returns possible appointments. If patient has more than one appointment, possible appointments time can be before the existing appointment, between two appointments, or at the end of the last appointment. Thus, web application enables the patient to reserve desirable appointment time.

On the waiting time distribution in a generalized queueing system with uniformly bounded sojourn times

1972 ◽  
Vol 9 (3) ◽  
pp. 642-649 ◽  
Author(s):  
Jacqueline Loris-Teghem
Keyword(s):  
Generating Function ◽  
Waiting Time ◽  
Service Time ◽  
Time Distribution ◽  
Queueing System ◽  
Waiting Time Distribution ◽  
Stieltjes Transform ◽  
Sojourn Times ◽  
Stieltjes Transforms ◽  
Uniformly Bounded

A generalized queueing system with (N + 2) types of triplets (delay, service time, probability of joining the queue) and with uniformly bounded sojourn times is considered. An expression for the generating function of the Laplace-Stieltjes transforms of the waiting time distributions is derived analytically, in a case where some of the random variables defining the model have a rational Laplace-Stieltjes transform.The standard Kl/Km/1 queueing system with uniformly bounded sojourn times is considered in particular.

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