Development of appointment scheduling rules for open access scheduling
In the early 1990s, a new appointment scheduling concept for outpatient clinics, labeled open access scheduling, advanced access scheduling, or same-day scheduling, was introduced to improve quality of healthcare and reduce the cost of healthcare delivery. The concept becomes popular in medical practices nowadays because it addresses two of the six key aims for healthcare quality improvement targeted by Institute of Medicine: timely care and patient-centered care. However, this concept, still under development, is far from mature, and the critical parameters in open access scheduling are still determined by experience rather than quantitative methods. In this research, mathematical models and quantitative procedures are developed to optimize critical parameters in open access scheduling, and the general guidelines to choose appropriate parameters are obtained by investigating the impacts of clinic environmental characteristics on the optimal parameters. The critical parameters optimized include the percentage of open-access appointments, the time horizon of open-access appointments, and a scheduling template for each provider in each clinic session. First, several efficient quantitative procedures are developed to determine the optimal or Pareto optimal percentages of prescheduled and open-access appointments for a provider in a clinic session. Then, by combining tabu search and Ranking and Selection approach, a heuristic procedure is developed to optimally allocate appointment slots to prescheduled and open-access appointments for a provider in a session. Using these procedures, we investigate the impacts of time horizon of open-access appointments and clinic environmental characteristics on the performance of open access scheduling, and then summarize the general guidelines for clinic administrators to choose a best scheduling policy for each provider in each clinic session in the clinics implementing open access scheduling. These quantitative approaches and general guidelines can decrease the probability of failure to implement open access scheduling, and improve the performance of open access scheduling.
Rardin, Purdue University.
Off-Campus Purdue Users:
To access this dissertation, please log in to our