Outpatient Appointment Block Scheduling Under Patient Heterogeneity and Patient No-Shows
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We study outpatient appointment block scheduling policies for single providers under conditions of patient heterogeneity in service times and patient noshows. The objective is to find daily appointment schedules that minimize a weighted sum of patients waiting time, the physician's idle time, and the physician's overtime. We contribute by suggesting new effective sequential block scheduling procedures motivated by actual outpatient clinic practices across the globe and grounded in the successful Toyota Production System load smoothing approach. Our block scheduling policy first assigns a sequence of different patient types within a time block. The policy then allocates repetitive blocks across a planning horizon. We start our analysis by studying the case with zero probability of noshows. Under the setting that the physician's idle time is zero, we propose a polynomial time optimal scheduling approach for two patient types, before demonstrating that the problem with at least three patient types is NPHard. Various extensions to incorporate practical outpatient clinic environment dimensions are considered. We then extend our scheduling approach to incorporate reasonable patient noshow probabilities. Finally, our block scheduling approach is adapted for scenarios where outpatient clinics use an openaccess scheduling environment, where patients make sameday appointments. We compare our block scheduling policies against extant scheduling policy, finding our block scheduling policies surpass the benchmark method.
