Enabling patients to walk in for their diagnostic examination without an appointment has considerable potential in terms of quality of care, patient service, and system efficiency. We present a model to evaluate the effect of implementing a combined walk-in and appointment system, offering appointments to all patients preferring or strictly requiring these, while enabling all other patients to walk in. In a combined system, appointments can be scheduled in periods with low walk-in demand to counterbalance the possible high variability in walk-in arrival rates. We develop a discrete event simulation model, combined with an intelligent algorithmic methodology for appointment schedule optimization, for evaluating the implementation of a combined walk-in and appointment system for diagnostic examinations. Our simulation model is reusable: its component-based structure and generic underlying logic enable it to automatically represent any type of diagnostic facility, for which it can then evaluate the effect of implementing a combined walk-in and appointment system. Applying this approach, we quantitatively investigate the impact of implementing a combined walk-in and appointment system for CT-scans, performing a case study at the Academic Medical Center (AMC) Amsterdam. Inspired by the results, the AMC CT-facility has implemented a combined walk-in and appointment system, thereby shortening patients’ diagnostic trajectories, and decreasing the number of required hospital visits for many patients.
- Health services accessibility
- Diagnostic services
- Discrete Event Simulation
- Appointments and schedules
- Computed tomography scans