title: Impact of adjustment measures on reducing outpatient waiting time in a community hospital: application of a computer simulation.
abstract: BACKGROUND
  As an important determinant of patient satisfaction, waiting time, has gained increasing attention in the field of health care services. The present study aimed to illustrate the distribution characteristics of waiting time in a community hospital and explore the impact of potential measures to reduce outpatient waiting time based on a computer simulation approach.
  
  
  METHODS
  During a one-month study period in 2006, a cross-sectional study was conducted in a community hospital located in Shanghai, China. Baseline data of outpatient waiting time were calculated according to the records of registration time and payment time. A simulation technique was adopted to investigate the impact of perspective reform methods on reducing waiting time.
  
  
  RESULTS
  Data from a total of 10,092 patients and 26,816 medical consultations were collected in the study and 19,947 medical consultations were included. The average of the total visit time for outpatients in this hospital was 43.6 minutes in the morning, 19.1 minutes in the afternoon, and 34.3 minutes for the whole day studied period. The simulation results suggested that waiting time for outpatients could be greatly reduced through the introduction of appointment system and flexible demand-orientated doctor scheduling according to the numbers of patients waiting at different time of the workday.
  
  
  CONCLUSIONS
  Adoption of an appointment system and flexible management of doctor scheduling may be effective way to achieve decreased waiting time.
authors.affiliation: Department of Medical Information and Management Science, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho Showa-ku Nagoya, Japan. chenbailian69@hotmail.com
authors.forename: Bai-lian
authors.initials: BL
authors.lastname: Chen
authors.forename: En-dong
authors.initials: ED
authors.lastname: Li
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Yamawuchi
authors.forename: Ken
authors.initials: K
authors.lastname: Kato
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
authors.forename: Wei-jun
authors.initials: WJ
authors.lastname: Miao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D003198:Computer Simulation; D003430:Cross-Sectional Studies; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D017060:Patient Satisfaction; D013997:Time Factors