A decision-support simulator for improving patient flow and increasing capacity at an eye outpatient department

One of the growing healthcare needs in Hong Kong is eye disease treatment. We conducted a study at an eye outpatient department of a public hospital and developed a decision support tool based on computer simulation to serve several purposes: (1) identify dynamic bottlenecks, subject to changes in the layout, input parameters, patient scheduling and resources allocation plan, (2) estimate time-based and congestion performance measures in the multi-phase queuing system serving multiple patient classes with different flow sequences, (3) assess the impact of improvement scenarios with the aim to increase service capacity (patient quota per session), and (4) enable hospital management to understand the operational situation and identify room for improvement. The improvement scenarios explored include scheduling by patient type; adaptive scheduling to relieve dynamic bottleneck; allocation of resource in near bottleneck operation for patients with small operation times; workload balancing (of compatible resources) between the light and bottleneck operations; (partial) automation of operation with standard procedure; and increasing service capacity (patient quota) by combining promising improvement scenarios.