Master of Science in Industrial Engineering (MSIE)
Healthcare costs in the United States are one of the highest in the world. The healthcare expenditure alone accounted for 17.9% of the Gross Domestic Product of US in 2011. The National Healthcare Expenditure (NHE) is expected to increase at an annual rate of 6.6% from $ 2.6 Trillion in 2010 to $ 4.5 Trillion in 2019. The per capita expenditure for hospital outpatients and physicians has been the highest among other hospital expenses. This escalation in expenses created a need for productivity improvements in the healthcare industry to control costs. Some of the common problems encountered in outpatient clinics are high patient wait times, physician idle times, physician overtimes and high patient congestion. These problems not only lead to the inefficient operation of a clinic but also cause frustration and dissatisfaction to the physicians and patients. A well designed appointment system is very critical for the effective operation of outpatient clinics by minimizing these problems. The objective of this research was to study the effect of different appointment systems on the operational performance of a university medical clinic. The process at the medical clinic in the LSU Student Health Center (SHC) was modeled using the Rockwell Arena® simulation software. Four scheduling rules: Individual block rule, Bailey rule, 3-Bailey rule, and the Two-at-a-time rule, were studied to understand their effect on the performance parameters of the SHC. The performance parameters considered were the provider measures (provider idle time, startup idle time, provider overtime, provider utilization) and patient measures (patient wait time and patient throughput time). The individual block rule was the most patient friendly with shortest patient measures (patient throughput time - 39.6 min and patient wait time - 15.5 min); however it had the highest provider measures (Idle time – 50.5 min, Startup idle time – 10.4 min, Overtime – 16.2 min). The 3-Bailey rule was the most provider friendly rule with the least provider times (Idle time – 17 min, Startup idle time – 4.6 min, Overtime – 5.6 min) and best provider utilization (95%), but had high patient times (throughput time – 48.1 min and wait time – 24.1 minute). To aid the decision making process of the schedule selection for the SHC, a KT analysis was performed by weighing the performance parameters. The Bailey rule was observed to be the most suitable rule for the SHC as it had a good trade-off between the patient times and provider times compared to the other rules. The Bailey rule had better provider times (Idle time – 31.8 min, Startup idle time – 6.5 min, Overtime – 6.9 min) and better provider utilization rate (92%) when compared to the individual block rule and had marginally higher patient times (throughput time – 41.4 min and wait time – 17.3 min). A test run of the Bailey rule with one provider for ten days also confirmed this behavior of the rule.
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Pisharody Vijayan, Arunn, "Effect of Appointment Schedules on the Operational Performance of a University Medical Clinic" (2015). LSU Master's Theses. 1871.