Capacity management and patient scheduling in an outpatient clinic using discrete event simulation

Capacity management and scheduling decisions are important for managing an outpatient clinic in which multiple classes of patients are treated. After an appointment is scheduled, it can be rescheduled, cancelled, or a patient may not show-up on their appointment day. This study simulates the behavior of patients with regard to the time to appointment, examining different demand rates and service times for each patient class (new external patients, internal patients, established patients and subsequent visit patients); we also consider different delay-dependent reschedule, cancellation, and no-show rates. A discrete event simulation model is developed to analyze the effects of allowing different appointment windows, i.e., the maximum time between the appointment request date and the actual appointment date, for different patient classes. Capacity utilization, patient access, and financial rewards are used as the performance indicators.