Case Study: Simple Health Clinic – Scheduled Appointments

Submitted: 10 Sep 2017

Operations Research Topics: SimulationModelling

Application Areas: Healthcare

Problem Description

This case study extends the Simple Health Clinic (SHC) model. In that case study walk-up patents waited for treatment by a doctor. In this case study an additional doctor is present in the clinic, one that sees patients with scheduled appointments. The second doctor can also treat walk up patients if they are free.

The goal of this simulation study is to analyse the average time patients spend:

waiting for treatment; and
in the clinic;

and the average length of the patient queue (which informs waiting room size). This analysis will include a comparison of the walk-up vs scheduled patients.

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Problem Formulation

In order to formulate a simulation model we specify the following components:

Background – problem description
Objectives of the study
Expected benefits
The CM: inputs, outputs, content, assumptions, simplifications’
Experiments to run

Components 1(Background – problem description) and 2 (Objectives of the study) are given in the Problem Description section (see paragraph describing the goal of the simulation study to identify study objectives).

The Expected benefits (component 3) are a virtual environment for evaluating patient waiting times, total time patients spend in the clinic, and the number of patients waiting for treatment. This environment can be used to experiment with changes to the clinic, including a comparison of effects on the waiting times, queue length, etc for the walk-up vs the scheduled patients.

The CM content is specified using the following components:

Component List
Process flow diagram
Logic flow diagram
Activity cycle diagram

Component List

The components of the Simple Health Clinic model are:

Walk-up patients with their (inter)arrival times
Scheduled patients with their appointment times
Doctors with their treatment times
Waiting room with its capacity

Process Flow Diagram

Patient Logic Flow Diagram		Doctor Logic Flow Diagrams

Activity Cycle Diagram

Once the content has been established (note this is usually an iterative process) we can identify the inputs and outputs: appointment times, interarrival times, treatment times, waiting times (Patient arrives to Doctor sees patient), total clinic time (Patient arrives to Outside), number in waiting room.

Assumptions are used to define stochasticity (e.g., Exponential interarrivals, Triangular treatment times) and the simplifications keep the system simple (e.g., one doctor on all day, no registration, no prioritisation).

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