Title: Design and analysis of a hybrid appointment system for patient scheduling: an optimisation approach

Authors: Sharan Srinivas; Mohammad T. Khasawneh

Addresses: Department of Industrial and Manufacturing Systems Engineering, and Department of Marketing, University of Missouri, Columbia, MO 65211, USA ' Department of Systems Science and Industrial Engineering, Binghamton University, Binghamton, NY 13902, USA

Abstract: This paper proposes a mixed integer linear programming (MILP) model for a hybrid appointment system (HAS) that schedules patients based on their preference while minimising the total loss of the system. The HAS proposed is a combination of three scheduling methods, namely walk-ins, pre-booked, and open access. The model supports the decision maker in determining the rejection and overtime rates of the health system under consideration. The HAS is analysed for the impact of different parameters, namely proportion of patients requesting open access (OA ratio), patient no-shows, and variation of service time on the optimal rejection rate and overtime rate. The results indicated that the HAS can handle variations in clinic's operational factors (variation of at least 20% in OA ratio and service time) without significantly impacting the performance measures. Furthermore, sensitivity analysis indicated that the model is not impacted when the demand fluctuation is within 40%.

Keywords: patient scheduling; hybrid appointment system; HAS; open access; pre-book; walk-ins; mixed integer programming; rejection rate; overtime rate; total loss.

DOI: 10.1504/IJOR.2017.084344

International Journal of Operational Research, 2017 Vol.29 No.3, pp.376 - 399

Received: 26 Jul 2014
Accepted: 09 Apr 2015

Published online: 06 Jun 2017 *

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