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A delay-scheduling model for patients using a walk-in clinic
Authors:Thomas A Reilly MD  Dr Vijay P Marathe PhD  Dr Brant E Fries PhD
Institution:1. the City Hospital Center at Elmhurst, Elmhurst, New York
2. Yale School of Organization and Management, New Haven, Connecticut
Abstract:Clinics receiving unscheduled visits experience wide fluctuations in the number of patients present at any one time, due to random arrival of patients and variations in the time needed for the evaluation and treatment. This can cause periods of congestion and long patient waiting times. Using a flexible technique for “delay scheduling,” a study was conducted to determine the most efficient use of limited physician resources in the management of patients using a walk-in clinic. Delay scheduling makes it possible to shift work load from periods of high congestion to other times without compromising the walk-in nature of the clinic. A computer simulation model was used to evaluate the clinic performance with different physician staffing patterns and different rules for delay scheduling. The model was validated using actual data from the walk-in clinic and the results implemented. The delay scheduling and staffing changes resulted in reduction of manpower by 10% while significantly reducing the clinicaccountable waiting time.
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