Simulation Analysis of Outpatient Appointment Scheduling of Minneapolis VA Dental Clinic

Abstract

Providing quality and timely care to patients has been a constant challenge to the healthcare industry. Long waiting hours and unavailability of timely appointments is a major source of dissatisfaction among patients. This thesis aims at studying the current scheduling practices and understanding the shortcomings of the Veterans’ Affairs (VA) dental outpatient clinic in Minneapolis, MN. The clinic is confronted with both long waiting hours and unavailability of appointment slots for patients and extended working hours for the staff. The hospital management reported that the average wait time to get an appointment is approximately 60 days. Time measurements, observations, and data mining in the clinic’s management information system show the performance of the outpatient clinic in the current scenario. After analyzing the data, simulation models of the dental clinic were created based on the parameters obtained from the collected data. Based on the pitfalls and performance metrics of the current scheduling system, three appointment configurations have been suggested. The appointment schedules have been modeled and compared with the current system. The model evaluated the performances of the clinic using theoretical probability distribution for patient arrivals and consultation times as input parameters. Current scheduling system has four appointment types with 30, 60, 90 and 120 minute durations. Modifications were suggested to the present model based on logical reasoning and statistical data obtained from the simulation model. The model was simulated with fewer number of appointment types to reduce the complexity of the system and see the effect on the resource utilization and wait times in the clinic. In the second scenario, appointments were given with a pool of resources rather than individual resources, in an attempt to reduce the wait times. The simulation results suggested that desirable effects on the resource utilization can be brought about by employing minor changes to the present system. A new method for allocating hygienists has been suggested which reduces the wait times by more than seventy percent. As a result of the reduced wait times; more patients can be treated by the clinic on a daily basis, which would reduce the access delays significantly.