title: Patient-centered appointment scheduling using agent-based simulation.
abstract: Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling.
authors.affiliation: Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA.
authors.forename: Ayten
authors.initials: A
authors.lastname: Turkcan
authors.affiliation: Department of Nursing, Indiana University Purdue University, Fort Wayne, IN.
authors.forename: Tammy
authors.initials: T
authors.lastname: Toscos
authors.affiliation: School of Informatics and Computing, Indiana University Purdue University, Indianapolis, IN.
authors.forename: Brad N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D001071:Appointments and Schedules; D003198:Computer Simulation; D006801:Humans; D010349:Patient Compliance; D018802:Patient-Centered Care; D011320:Primary Health Care / Q000458:organization & administration; D014584:User-Computer Interface; D057188:Workflow