Assessing the viability of an open access policy in an outpatient clinic: a discrete-event and continuous simulation modeling approach

This paper presents the preliminary results of an ongoing research project investigating the patient appointment scheduling for an outpatient clinic. The outpatient clinic was experiencing three problems of long patient throughput times, a large backlog of appointments, and a high no-show rate. We believe a new scheduling approach called open access could address all three problems. To analyze and make recommendations for improvement to patient cycle time we developed a discrete event simulation. To understand the factors leading to a high no-show rate we developed a systems dynamic simulation model. The study identified feasible strategies the clinic management could implement to greatly improve patient throughput time by 50%. Our preliminary results indicate that open access is a viable strategy for the clinic. Ongoing work is being conducted to refine the models and determine the best configuration of an open access scheduling policy for the outpatient clinic