Analysis of Slot Allocation Strategies and their Impacts on Appointment Waiting Time in Context of Outpatient Clinics

2011 ◽  
Vol 3 (3) ◽  
pp. 29-41
Author(s):  
Zhu Zhecheng
Keyword(s):  
Waiting Time ◽  
Service Providers ◽  
Discrete Event ◽  
Outpatient Clinics ◽  
Performance Measurements ◽  
Slot Allocation ◽  
Healthcare Facilities ◽  
Patient Request ◽  
Allocation Strategies

One prevailing problem in outpatient clinics with appointment systems in Singapore is that patients have to wait a long time for an available slot once they make requests. Such a long wait may negatively impact on the access to healthcare facilities, patient safety and satisfaction, etc. In recent years, such a problem is becoming worse due to the aging society and growing population. Besides the pressure of increasing demand, healthcare service providers in outpatient clinics are facing other challenges such as the complexity of patient request types, e.g., urgent or normal requests, requests for new or follow-up visit, etc. How to allocate the limited slots to meet the requirements of different requests is one of the performance measurements in outpatient clinics. In this paper, discrete event simulation is applied to study different slot allocation strategies and their impacts on waiting time. The dynamics between new visits and follow-up visits are analyzed as well.

Reducing Consultation Waiting Time and Overtime in Outpatient Clinic

2011 ◽  
pp. 229-245
Author(s):  
Zhu Zhecheng ◽  
Heng Bee Hoon ◽  
Teow Kiok Liang
Keyword(s):  
Patient Safety ◽  
Design Of Experiments ◽  
Discrete Event Simulation ◽  
Waiting Time ◽  
Outpatient Clinic ◽  
Performance Indicators ◽  
Discrete Event ◽  
Outpatient Clinics ◽  
Event Simulation ◽  
Growing Population

Outpatient clinics face increasing pressure to handle more appointment requests due to aging and growing population. The increase in workload impacts two critical performance indicators: consultation waiting time and clinic overtime. Consultation waiting time is the physical waiting time a patient spends in the waiting area of the clinic, and clinic overtime is the amount of time the clinic is open beyond its normal opening hours. Long consultation waiting time negatively affects patient safety and satisfaction, while long clinic overtime negatively affects the morale of clinic staff. This chapter analyzes the complexity of an outpatient clinic in a Singapore public hospital, and factors causing long consultation waiting time and clinic overtime. Discrete event simulation and design of experiments are applied to quantify the effects of the factors on consultation waiting time/clinic overtime. Implementation results show significant improvement once those factors are well addressed.

scholarly journals The Effectiveness of Using Discrete Event Simulation to Optimize the Quality of Service of Outpatient in Iraq: A Case Study

2021 ◽  
Vol 8 (1) ◽  
pp. 40-49
Author(s):  
Maysoon A. Mohammed ◽  
Shaymaa Kadhim Mohsin ◽  
Sarah Jasim Mohammed
Keyword(s):  
Waiting Time ◽  
Discrete Event ◽  
Outpatient Clinics ◽  
Discrete Events ◽  
Event Simulation ◽  
Dental Clinics ◽  
Long Time ◽  
Rich Material

One of the most important healthcare institutions in Iraq is Outpatient clinic that requires a lot of thinking to improve the way to provide services and the nature of care. Outpatient clinics are increasingly keen to meet the needs of care, and this has been recognized as a fundamental issue related to service quality. Therefore, many researchers in various fields have taken this matter as a basis for their research, as it is considered a rich material for research due to the problems these institutions contain. The most important problems faced by outpatient clinics are the waiting time and the insufficient number of clinic staff to perform the various tasks. The aim of this paper is to reduce the waiting time by building a model for the clinic environment, especially dental clinics, and trying to benefit from all the existing medical staff and exploit their experiences. Since the patient spends a long time between registration, returning to the doctor and finally the result or process that the doctor performs, building such a model might help in identifying and improving the problem. The simulation model built in this research for the clinic is based on modelling the discrete events inside the dental clinic using the Arena software. This form is used to assess the quality of services provided by dental outpatient clinics in Iraq.

scholarly journals Quality Assessment of the Services Delivered by a Court, Based on the Perceptions of Users, Magistrates, and Court Officials

2021 ◽  
Vol 13 (2) ◽  
pp. 504
Author(s):  
Patrícia Moura e Sá ◽  
Maria João Rosa ◽  
Gonçalo Santinha ◽  
Cátia Valente
Keyword(s):  
Service Quality ◽  
Service Providers ◽  
Service Performance ◽  
Technological Equipment ◽  
Perceived Service Quality ◽  
Positive View ◽  
Depth Interview

This paper aims to measure the quality of the services delivered by a court by assessing the satisfaction of court users and service providers, i.e., magistrates and court officials. For that purpose, a case study was carried out and data were collected by means of a questionnaire based on the SERVPERF instrument, in which perceived service quality is measured, considering court users, magistrates, and court officials’ perceptions of post-service performance. One hundred and fifty-eight questionnaires were successfully returned. An in-depth interview was later conducted to the court administrator to gain a richer understanding of the results achieved and ask follow-up questions. Overall, findings revealed that court users, magistrates, and court officials clearly have a positive view of the services provided, although improvement is needed, particularly in the court’s facilities and technological equipment. The current research sheds some light on the potentialities and difficulties of assessing service quality in the judiciary and contributes to the validation of the SERVPERF instrument in this context.

scholarly journals Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Ponsian Patrick Paul ◽  
Anita Makins
Keyword(s):  
Service Providers ◽  
International Federation ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Gynecology And Obstetrics ◽  
Intrauterine Contraceptive ◽  
The Difference

Abstract Background The insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge which can help them in counselling their PPIUD clients. Objective Establish impact of postpartum TCu380A on amount and duration of lochia. Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6th week. Lochia was estimated by Likert Scale 0–4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired 20% difference in the proportion of women with prolonged lochia discharges among the Exposed and Unexposed groups. Data analysis was by SPSS. Results Two hundred sixty women were analysed, 127 Exposed and 133 Unexposed. Medical complaints were reported by 41 (28.9%) Exposed and 37 Unexposed (27.8%), p = 0.655. Lack of dryness by end of 6th week was to 31 (23.3%) Exposed and 9 (7.1%) Unexposed, p < 0.001. Exposed had higher weekly mean lochia scores throughout with the difference most marked in 5th week (3.556 Versus 2.039, p < 0.001) and 6th week (1.44 Versus 0.449, p<0.001). Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of PPIUD clients’ needs to be informed about the possibility of delayed dryness of lochia at time of counseling are discussed.

493 Evaluation of Patient Waiting Times for Plain Radiographs Whilst Attending Outpatient Clinics in A Tertiary Orthopaedic Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hayat ◽  
E Kinene ◽  
S Molloy
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Time Frame ◽  
Outpatient Clinics ◽  
Contributing Factors ◽  
Time Data ◽  
Work Related ◽  
Mean Waiting Time ◽  
Appointment Time ◽  
Related Stress

Abstract Introduction Reduction of waiting times is key to delivering high quality, efficient health care. Delays experienced by patients requiring radiographs in orthopaedic outpatient clinics are well recognised. Method To establish current patient and staff satisfaction, questionnaires were circulated over a two-week period. Waiting time data was retrospectively collected including appointment time, arrival time and the time at which radiographs were taken. Results 84% (n = 16) of radiographers believed patients would be dissatisfied. However, of the 296 patients questioned, 56% (n = 165) were satisfied. Most patients (89%) felt the waiting time should be under 30 minutes. Only 36% were seen in this time frame. There was moderate negative correlation (R=-0.5); higher waiting times led to increased dissatisfaction. Mean waiting time was 00:37 and the maximum 02:48. Key contributing factors included volume of patients, staff shortages (73.7%), equipment shortages (57.9%) and incorrectly filled request forms. Eight (42.1%) had felt unwell from work related stress. Conclusions A concerted effort is needed to improve staff and patient opinion. There is scope for change post COVID. Additional training and exploring ways to avoid overburdening the department would benefit. Numerous patients were open to different days or alternative sites. Funding requirements make updating equipment, expanding the department and recruiting more staff challenging.

scholarly journals Simulation modeling and analysis of primary health center operations

SIMULATION ◽  
2021 ◽  
pp. 003754972110309
Author(s):  
Mohd Shoaib ◽  
Varun Ramamohan
Keyword(s):  
Resource Utilization ◽  
Waiting Times ◽  
Discrete Event ◽  
Simulation Models ◽  
Modeling And Analysis ◽  
Healthcare Facilities ◽  
Event Simulation ◽  
Analytical Approximations ◽  
Primary Health ◽  
Generic Modeling

We present discrete-event simulation models of the operations of primary health centers (PHCs) in the Indian context. Our PHC simulation models incorporate four types of patients seeking medical care: outpatients, inpatients, childbirth cases, and patients seeking antenatal care. A generic modeling approach was adopted to develop simulation models of PHC operations. This involved developing an archetype PHC simulation, which was then adapted to represent two other PHC configurations, differing in numbers of resources and types of services provided, encountered during PHC visits. A model representing a benchmark configuration conforming to government-mandated operational guidelines, with demand estimated from disease burden data and service times closer to international estimates (higher than observed), was also developed. Simulation outcomes for the three observed configurations indicate negligible patient waiting times and low resource utilization values at observed patient demand estimates. However, simulation outcomes for the benchmark configuration indicated significantly higher resource utilization. Simulation experiments to evaluate the effect of potential changes in operational patterns on reducing the utilization of stressed resources for the benchmark case were performed. Our analysis also motivated the development of simple analytical approximations of the average utilization of a server in a queueing system with characteristics similar to the PHC doctor/patient system. Our study represents the first step in an ongoing effort to establish the computational infrastructure required to analyze public health operations in India and can provide researchers in other settings with hierarchical health systems, a template for the development of simulation models of their primary healthcare facilities.

Microbial bioburden of inpatient and outpatient areas beyond patient hospital rooms

2021 ◽  
pp. 1-5
Author(s):  
Jennifer L. Cadnum ◽  
Basya S. Pearlmutter ◽  
Annette L. Jencson ◽  
Hanan Haydar ◽  
Michelle T. Hecker ◽  
...  
Keyword(s):  
Bacterial Pathogens ◽  
Outpatient Clinics ◽  
Acinetobacter Baumanii ◽  
Healthcare Facilities ◽  
Fluorescent Markers ◽  
Clostridioides Difficile ◽  
Vancomycin Resistant ◽  
Healthcare Associated ◽  
Cleaning And Disinfection ◽  
Surgery Center

Abstract Objective: To investigate the frequency of environmental contamination in hospital areas outside patient rooms and in outpatient healthcare facilities. Design: Culture survey. Setting: This study was conducted across 4 hospitals, 4 outpatient clinics, and 1 surgery center. Methods: We conducted 3 point-prevalence culture surveys for methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridioides difficile, Candida spp, and gram-negative bacilli including Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumanii, and Stenotrophomonas maltophilia in each facility. In hospitals, high-touch surfaces were sampled from radiology, physical therapy, and mobile equipment and in emergency departments, waiting rooms, clinics, and endoscopy facilities. In outpatient facilities, surfaces were sampled in exam rooms including patient and provider areas, patient bathrooms, and waiting rooms and from portable equipment. Fluorescent markers were placed on high-touch surfaces and removal was assessed 1 day later. Results: In the hospitals, 110 (9.4%) of 1,195 sites were positive for 1 or more bacterial pathogens (range, 5.3%–13.7% for the 4 hospitals) and 70 (5.9%) were positive for Candida spp (range, 3.7%–5.9%). In outpatient facilities, 31 of 485 (6.4%) sites were positive for 1 or more bacterial pathogens (range, 2% to 14.4% for the 5 outpatient facilities) and 50 (10.3%) were positive for Candida spp (range, 3.9%–23.3%). Fluorescent markers had been removed from 33% of sites in hospitals (range, 28.4%–39.7%) and 46.3% of sites in outpatient clinics (range, 7.4%–82.8%). Conclusions: Surfaces in hospitals outside patient rooms and in outpatient facilities are frequently contaminated with healthcare-associated pathogens. Improvements in cleaning and disinfection practices are needed to reduce contamination.

scholarly journals Balancing scarce hospital resources during the COVID-19 pandemic using discrete-event simulation

2021 ◽  
Author(s):  
G.J. Melman ◽  
A.K. Parlikad ◽  
E.A.B. Cameron
Keyword(s):  
Resource Allocation ◽  
Discrete Event Simulation ◽  
Elective Surgery ◽  
Discrete Event ◽  
Specific Patient ◽  
Event Simulation ◽  
The Impact ◽  
Allocation Decisions ◽  
Allocation Strategies ◽  
Resource Allocation Decisions

AbstractCOVID-19 has disrupted healthcare operations and resulted in large-scale cancellations of elective surgery. Hospitals throughout the world made life-altering resource allocation decisions and prioritised the care of COVID-19 patients. Without effective models to evaluate resource allocation strategies encompassing COVID-19 and non-COVID-19 care, hospitals face the risk of making sub-optimal local resource allocation decisions. A discrete-event-simulation model is proposed in this paper to describe COVID-19, elective surgery, and emergency surgery patient flows. COVID-19-specific patient flows and a surgical patient flow network were constructed based on data of 475 COVID-19 patients and 28,831 non-COVID-19 patients in Addenbrooke’s hospital in the UK. The model enabled the evaluation of three resource allocation strategies, for two COVID-19 wave scenarios: proactive cancellation of elective surgery, reactive cancellation of elective surgery, and ring-fencing operating theatre capacity. The results suggest that a ring-fencing strategy outperforms the other strategies, regardless of the COVID-19 scenario, in terms of total direct deaths and the number of surgeries performed. However, this does come at the cost of 50% more critical care rejections. In terms of aggregate hospital performance, a reactive cancellation strategy prioritising COVID-19 is no longer favourable if more than 7.3% of elective surgeries can be considered life-saving. Additionally, the model demonstrates the impact of timely hospital preparation and staff availability, on the ability to treat patients during a pandemic. The model can aid hospitals worldwide during pandemics and disasters, to evaluate their resource allocation strategies and identify the effect of redefining the prioritisation of patients.

Sharp Decrease of Reported Occupational Blood and Body Fluid Exposures in French Hospitals, 2003–2012: Results of the French National Network Survey, AES-RAISIN

2015 ◽  
Vol 36 (8) ◽  
pp. 963-968 ◽  
Author(s):  
N. Floret ◽  
O. Ali-Brandmeyer ◽  
F. L’Hériteau ◽  
C. Bervas ◽  
S. Barquins-Guichard ◽  
...  
Keyword(s):  
Body Fluid ◽  
Sharp Decrease ◽  
Healthcare Personnel ◽  
Significant Drop ◽  
Healthcare Facilities ◽  
National Network ◽  
The Past ◽  
Personnel Safety ◽  
Voluntary Basis

OBJECTIVETo assess the temporal trend of reported occupational blood and body fluid exposures (BBFE) in French healthcare facilities.METHODRetrospective follow-up of reported BBFE in French healthcare facilities on a voluntary basis from 2003 to 2012 with a focus on those enrolled every year from 2008 to 2012 (stable cohort 2008–12).FINDINGSReported BBFE incidence rate per 100 beds decreased from 7.5% in 2003 to 6.3% in 2012 (minus 16%). Percutaneous injuries were the most frequent reported BBFE (84.0% in 2003 and 79.1% in 2012). Compliance with glove use (59.1% in 2003 to 67.0% in 2012) and sharps-disposal container accessibility (68.1% in 2003 to 73.4% in 2012) have both increased. A significant drop in preventable BBFE was observed (48.3% in 2003 to 30.9% in 2012). Finally, the use of safety-engineered devices increased from 2008 to 2012.CONCLUSIONOf the 415,209 hospital beds in France, 26,158 BBFE could have occurred in France in 2012, compared with 35,364 BBFE in 2003. Healthcare personnel safety has been sharply improved during the past 10 years in France.Infect. Control Hosp. Epidemiol. 2015;36(8):963–968

Satisfaction of tuberculosis patients with health services in Ghana

2017 ◽  
Vol 30 (6) ◽  
pp. 545-553 ◽  
Author(s):  
Frank Bonsu ◽  
Felix Afutu ◽  
Nii Nortey Hanson-Nortey ◽  
Mary-Anne Ahiabu ◽  
Joshua Amo-Adjei
Keyword(s):  
Client Satisfaction ◽  
Service Providers ◽  
Healthcare Providers ◽  
Large Body ◽  
Service Users ◽  
Content Type ◽  
Sputum Production ◽  
Interview Guide

Purpose Within human services, client satisfaction is highly prioritised and considered a mark of responsiveness in service delivery. A large body of research has examined the concept of satisfaction from the perspective of service users. However, not much is known about how service providers construct client satisfaction. The purpose of this paper is to throw light on healthcare professionals’ perspectives on patient satisfaction, using tuberculosis (TB) clinics as a case study. Design/methodology/approach In-depth interviews were conducted with 35 TB clinic supervisors purposively sampled from six out of the ten regions of Ghana. An unstructured interview guide was employed. The recorded IDIs were transcribed, edited and entered into QSR NVivo 10.0 and analysed inductively. Findings Respondents defined service satisfaction as involving education/counselling (on drugs, nature of condition, sputum production, caregivers and contacts of patients), patient follow-up, assignment of reliable treatment supporters as well as being attentive and receptive to patients, service availability (e.g. punctuality at work, availability of commodities), positive assurances about disease prognosis and respect for patients. Practical implications Complementing opinions of health service users with those of providers can offer key performance improvement areas for health managers. Originality/value To the best of the authors’ knowledge, this is a first study that has examined healthcare providers’ views on what makes their clients satisfied with the services they provide.

Sign in / Sign up

Export Citation Format

Share Document