To Carve Out or Not: Managing the Routine and Same-day Appts for Outpatient Clinics

66 Pages Posted: 13 Jul 2021 Last revised: 14 Feb 2023

See all articles by Enayon Sunday Taiwo

Enayon Sunday Taiwo

Department of Business and Administration, University of Winnipeg

Sergei Savin

University of Pennsylvania - Operations, Information and Decisions Department

Frank (Youhua) Chen

City Univ. of Hong Kong - College of Business, Dept of Management Sciences

Kwai-Sang Chin

City University of Hong Kong - Department of Manufacturing Engineering & Engineering Management

Date Written: April 20, 2021

Abstract

Faced with challenges of patient no-show behavior in the advanced scheduling system and the demand variability effect in the open-access system, outpatient clinics may use a combination of both policies. When this happens, the typical decision rule is the "carve-out scheduling" (COS) policy. The COS system, which stipulates that the decision-maker cannot assign two patients of different classes to a slot, may often experience increasing underutilization and long waiting times. Alternatively, the policy "mixed appointment scheduling" (MAS), which allows for possible assignment of the two patient classes to a slot, may be desirable. Whether the MAS policy would perform better than the COS, and under what business settings are the performance gaps worthwhile, are questions we seek to address. We answer these questions by proposing a new model to determine the optimal appointment scheduling decision for routine and same-day patients under the MAS condition. We show that the priority service discipline, together with uncertainty in demand, destroys the multimodularity of the objective function in the component of the same-day schedule. Thus, the joint problem of determining the optimal routine and same-day schedules becomes hard to solve. We provide various characterizations that allow for the efficient identification of the optimal decision policy. Our numerical results reveal that the MAS policy helps to lower system cost, increase utilization, and reduce service delay when the same-day demand to clinic capacity ratio is within a moderate limit.

Suggested Citation

Taiwo, Enayon Sunday and Savin, Sergei and Chen, Frank (Youhua) and Chin, Kwai-Sang, To Carve Out or Not: Managing the Routine and Same-day Appts for Outpatient Clinics (April 20, 2021). Available at SSRN: https://ssrn.com/abstract=3884741 or http://dx.doi.org/10.2139/ssrn.3884741

Enayon Sunday Taiwo (Contact Author)

Department of Business and Administration, University of Winnipeg ( email )

Winnipeg, Manitoba R3B 2E9
Canada

Sergei Savin

University of Pennsylvania - Operations, Information and Decisions Department ( email )

3730 Walnut Street
546 Jon M. Huntsman Hall
Philadelphia, PA 19104-5340
United States

Frank (Youhua) Chen

City Univ. of Hong Kong - College of Business, Dept of Management Sciences ( email )

Kowloon Tong
Hong Kong

HOME PAGE: http://www.cb.cityu.edu.hk/staff/youhchen

Kwai-Sang Chin

City University of Hong Kong - Department of Manufacturing Engineering & Engineering Management ( email )

Kowloon
Hong Kong

HOME PAGE: http://roweb2.cityu.edu.hk:90/profile/770F.htm

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