A Capacity Allocation Planning Model for Integrated Care and Access Management

Abstract

The prevailing first-come-first-served approach to outpatient appointment scheduling ignores differing urgency levels, leading to unnecessarily long waits for urgent patients. In data from a partner healthcare organization, we found in some departments that urgent patients were inadvertently waiting longer for an appointment than non-urgent patients. This paper develops a capacity allocation optimization methodology that reserves appointment slots based on urgency in a complicated, integrated care environment where multiple specialties serve multiple types of patients. This optimization reallocates network capacity to limit access delays (indirect waiting times) for initial and downstream appointments differentiated by urgency. We formulate this problem as a queueing network optimization and approximate it via deterministic linear optimization to simultaneously smooth workloads and guarantee access delay targets.

In a case study of our industry partner we demonstrate the ability to (1) reduce urgent patient mean access delay by 27% with only a 7% increase in mean access delay for non-urgent patients, and (2) increase throughput by 31% with the same service levels and over.

Keywords: Advance Planning and Scheduling; Access Waiting Time Management; Health Care Operations; Patient Flow Modeling; Mixed Integer Programming; Queueing Networks