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An optimized queue management system to improve patient flow in the absence of appointment system

Komal Aqeel Safdar (Khalifa University, Abu Dhabi, UAE)
Ali Emrouznejad (Aston Business School, Aston University, Birmingham, UK)
Prasanta Kumar Dey (Aston Business School, Birmingham, UK)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 13 November 2020

Issue publication date: 25 November 2020




The aim of this research study is to develop a queue assessment model to evaluate the inflow of walk-in outpatients in a busy public hospital of an emerging economy, in the absence of appointment systems, and construct a dynamic framework dedicated towards the practical implementation of the proposed model, for continuous monitoring of the queue system.


The current study utilizes data envelopment analysis (DEA) to develop a combined queuing–DEA model as applied to evaluate the wait times of patients, within different stages of the outpatients' department at the Combined Military Hospital (CMH) in Lahore, Pakistan, over a period of seven weeks (23rd April to 28th May 2014). The number of doctors/personnel and consultation time were considered as outputs, where consultation time was the non-discretionary output. The two inputs were wait time and length of queue. Additionally, VBA programming in Excel has been utilized to develop the dynamic framework for continuous queue monitoring.


The inadequate availability of personnel was observed as the critical issue for long wait times, along with overcrowding and variable arrival pattern of walk-in patients. The DEA model displayed the “required” number of personnel, corresponding to different wait times, indicating queue build-up.


The current study develops a queue evaluation model for a busy outpatients' department in a public hospital, where “all” patients are walk-in and no appointment systems. This model provides vital information in the form of “required” number of personnel which allows the administrators to control the queue pre-emptively minimizing wait times, with optimal yet dynamic staff allocation. Additionally, the dynamic framework specifically targets practical implementation in resource-poor public hospitals of emerging economies for continuous queue monitoring.



Safdar, K.A., Emrouznejad, A. and Dey, P.K. (2020), "An optimized queue management system to improve patient flow in the absence of appointment system", International Journal of Health Care Quality Assurance, Vol. 33 No. 7/8, pp. 477-494.



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