title: Effects of clinical characteristics on successful open access scheduling.
abstract: Many outpatient clinics are experimenting with open access scheduling. Under open access, patients see their physicians within a day or two of making their appointment request, and long-term patient booking is very limited. The hope is that these short appointment lead times will improve patient access and reduce uncertainty in clinic operations by reducing patient no-shows. Practice shows that successful implementation can be strongly influenced by clinic characteristics, indicating that open access policies must be designed to account for local clinical conditions. The effects of four variables on clinic performance are examined: (1) the fraction of patients being served on open access, (2) the scheduling horizon for patients on longer-term appointment scheduling, (3) provider care groups, and (4) overbooking. Discrete event simulation, designed experimentation, and data drawn from an intercity clinic in central Indiana are used to study the effects of these variables on clinic throughput and patient continuity of care. Results show that, if correctly configured, open access can lead to significant improvements in clinic throughput with little sacrifice in continuity of care.
authors.affiliation: School of Industrial Engineering, Purdue University, 315 North Grant Street, West Lafayette, IN 47907, USA. rkopach@purdue.edu
authors.forename: Renata
authors.initials: R
authors.lastname: Kopach
authors.forename: Po-Ching
authors.initials: PC
authors.lastname: DeLaurentis
authors.forename: Mark
authors.initials: M
authors.lastname: Lawley
authors.forename: Kumar
authors.initials: K
authors.lastname: Muthuraman
authors.forename: Leyla
authors.initials: L
authors.lastname: Ozsen
authors.forename: Ron
authors.initials: R
authors.lastname: Rardin
authors.forename: Hong
authors.initials: H
authors.lastname: Wan
authors.forename: Paul
authors.initials: P
authors.lastname: Intrevado
authors.forename: Xiuli
authors.initials: X
authors.lastname: Qu
authors.forename: Deanna
authors.initials: D
authors.lastname: Willis
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001071:Appointments and Schedules; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D013997:Time Factors