Analysis of an Open Access Scheduling System in Outpatient Clinics: A Simulation Study

Abstract

Open access (OA) is a scheduling system which leaves the majority of the slots open to same-day appointments (SDAs). The OA is expected to reduce patient waiting time and no-show rate, and, in turn, increase clinic performance including patient satisfaction. Although many success stories have been reported, there is no study investigating the impact of OA configuration considering environmental conditions. In this paper, we conducted a simulation study in an outpatient clinic setting. The clinical environments we consider include the demand variability, no-show rate, and the ratio of SDA patients. The OA configurations are constructed by the slots for pre-book which is a complement of SDA and the scheduling horizon for the pre-book. The experimental results demonstrate the performance of different OA configurations under various clinical environments in terms of patient waiting time, patient rejection rate and clinic utilization. The results are scrutinized in the method of a multi-objective optimization.