Assessing appointment systems’ operational performance with policy targets

Abstract

We propose a paradigm shift in how the performance of outpatient clinic appointment schedules is evaluated in practice and academia. Our research addresses the traditional dilemma between patients’ wait times and providers’ idle time and overtime, but with operational performance metrics that assess their respective probabilities of exceeding established thresholds, instead of optimizing a presumed cost function. Using a stochastic model, we introduce a new way of analyzing appointment schedules that is absent from the literature but appealing to practitioners. We take into account the variable nature of patient consultation times, known differences in the duration of diverse consults, and patients’ propensity to miss their appointments. Analysis shows that traditional scheduling systems have serious shortcomings in terms of providing consistent service levels, and we conclude that the managerial decision space so far investigated in the appointment scheduling literature is not adequate for exercising operational control over appointment system performance.