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Abstract
This paper addresses the appointment scheduling problem in outpatient infusion centers using mathematical optimization and simulation. In the literature, various studies have addressed the appointment scheduling problem in infusion centers, however, these studies focused on chemotherapy treatment. There are some outpatient infusion centers, such as the case study used in this paper, that provide various treatment services not specific to chemotherapy. Thus, these infusion centers have different complexities and problem settings than those of cancer clinics. This paper aims at developing an optimal appointment schedule for an outpatient infusion center, part of a US-based community hospital, based on its historical data and problem settings with the objective of balancing nurses' workload. Same-day appointments are considered by inserting buffers into the schedule. Also, a probability-based criterion is proposed to address the uncertainty in appointments' duration times. The proposed optimal appointment schedule was tested using simulation to validate its robustness. The results show that the proposed schedule can reduce the average daily clinic overtime by 33% while maintaining the same throughput. Furthermore, the proposed model and simple rules, that handle the uncertainty in duration time, could be used to improve the appointment scheduling in similar outpatient infusion centers.
Keywords
Infusion Center, Appointment Scheduling, Overtime, Optimization, Simulation
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1.Introduction
The rapid growth in healthcare services demand, patient's expectation of quality of care and healthcare expenditures have emphasized on improving the efficiency of healthcare systems [1]. Therefore, healthcare organizations are constantly seeking to improve the quality of care while minimizing the cost [2]. Recently, outpatient clinics have become important components of the overall healthcare system [1] and their appointment systems are crucial for efficient healthcare delivery [3]. Outpatient infusion centers provide infusion therapy services, such as blood transfusions, antibiotic infusions and chemotherapy [4]. Infusion therapy involves the administration of all types of drug infusions via a needle or catheter, which is prescribed when the patient cannot be treated effectively through the oral route [4]. There are various studies that addressed the appointment scheduling problem in infusion centers including [1,2,5,6-8,10,11-13]. However, these studies addressed appointment scheduling of chemotherapy treatments. In cancer clinics, the upstream stages prior to drug administration including oncologist appointment, lab/image results and drug preparation should be considered in chemotherapy appointment scheduling...