A reusable simulation model to evaluate the effects of walk-in for diagnostic examinations

Aleida Braaksma, Nikky Kortbeek, Kees Smid, Marieke E.S. Sprengers

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Abstract

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.
Original languageEnglish
Pages (from-to)317-337
Number of pages21
JournalSimulation Modelling Practice and Theory
Volume77
DOIs
Publication statusPublished - 2017

Keywords

  • Health services accessibility
  • Diagnostic services
  • Discrete Event Simulation
  • Appointments and schedules
  • Computed tomography scans

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