Search results

1 – 10 of over 21000
Open Access
Article
Publication date: 5 April 2021

Alceu Salles Camargo Jr

The purpose of this paper is to evaluate the economic benefits of managing an outpatient appointments system with technological innovations.

Abstract

Purpose

The purpose of this paper is to evaluate the economic benefits of managing an outpatient appointments system with technological innovations.

Design/methodology/approach

This study uses a quantitative methodological procedures aiming to evaluate the cost-benefit relation and also the payback of the management and operation of an outpatient appointments system with technological innovations.

Findings

This study found a great benefit-cost relation of 30.6 showing the great economic value and social impact of managing an outpatient appointments regulation system with technological innovations.

Research limitations/implications

This study presents contribution to the literature discussion about the economic evaluation of the benefits of managing and operating more effective outpatient appointments systems because of important technological innovations.

Practical implications

This paper presents and discusses the most important and commonly used strategies and technological innovations to deal with and to manage an outpatient appointment regulation system aiming to reduce the patient no-show rates.

Social implications

The findings of this study show a great benefit-cost relation of about 30.6 which is being reverted to the society.

Originality/value

There not exist many similar studies in the pertinent literature, mostly with the Brazilian contexts.

Article
Publication date: 30 December 2021

Mohsen Abdoli, Mostafa Zandieh and Sajjad Shokouhyar

This study is carried out in one public and one private health-care centers based on different probabilities of patient’s no-show rate. The present study aims to determine…

Abstract

Purpose

This study is carried out in one public and one private health-care centers based on different probabilities of patient’s no-show rate. The present study aims to determine the optimal queuing system capacity so that the expected total cost is minimized.

Design/methodology/approach

In this study an M/M/1/K queuing model is used for analytical properties of optimal queuing system capacity and appointment window so that total costs of these cases could be minimized. MATLAB software version R2014a is used to code the model.

Findings

In this paper, the optimal queuing system capacity is determined based on the changes in effective parameters, followed by a sensitivity analysis. Total cost in public center includes the costs of patient waiting time and rejection. However, the total cost in private center includes costs of physician idle time plus costs of public center. At the end, the results for public and private centers are compared to reach a final assessment.

Originality/value

Today, determining the optimal queuing system capacity is one of the most central concerns of outpatient clinics. The large capacity of the queuing system leads to an increase in the patient’s waiting-time cost, and on the other hand, a small queuing system will increase the cost of patient’s rejection. The approach suggested in this paper attempts to deal with this mentioned concern.

Details

Journal of Modelling in Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-5664

Keywords

Article
Publication date: 9 September 2013

Samsul Islam, Tava Olsen and M. Daud Ahmed

Empty container trucks may cause a deficit in transport capacity and contribute to congestion and emissions in the port territory. Reengineering of the container truck…

2687

Abstract

Purpose

Empty container trucks may cause a deficit in transport capacity and contribute to congestion and emissions in the port territory. Reengineering of the container truck hauling process to introduce truck-sharing arrangements using the truck appointment system has the potential of reducing the number of empty-truck trips. The paper aims to discuss these issues.

Design/methodology/approach

This research evaluates the results from an investigation of the truck appointment system using a case study approach. The data collection phase involved primary and secondary sources along with using publicly available data on port operations.

Findings

The study explores a dynamic truck-sharing facility for a computer-based matching system to assign probable export containers to available empty slots of a container truck. The proposed model reengineers the truck appointment system with a potential to reduce the number of empty-truck trips to increase container transport capacity around seaport gates.

Research limitations/implications

Due to continuous increases in container-freight traffic, leading seaports of the world are experiencing a capacity shortage resulting in traffic congestion. The research findings are useful in practice as the proposed truck-sharing model can be introduced to enhance capacity in the container transport chain of the port territory.

Originality/value

The empty-trucks problem has not been addressed much in studies from a decentralized perspective where all truck operators have an equal chance to contribute to optimize the supply chain in contrast with the typical one-company-based optimization. The solution addressed here uses the shared-transportation concept to cover the research gap.

Details

Business Process Management Journal, vol. 19 no. 5
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 12 March 2018

Katie Phillips, Lucy N. Macintyre and Alison McMullan

In Scotland, individuals referred for NHS psychological therapies are expected to commence “treatment” within 18 weeks of receipt of referral. With high demand, high…

Abstract

Purpose

In Scotland, individuals referred for NHS psychological therapies are expected to commence “treatment” within 18 weeks of receipt of referral. With high demand, high non-attendance rates and limited capacity, this can be a challenging goal. The service discussed here was keen to develop a way of seeing individuals referred sooner and improving the efficiency of the assessment process. The purpose of this paper is to look at the impact of introducing assessment (“Signpost”) appointments on waiting times, attendance, and treatment planning.

Design/methodology/approach

Signpost appointments were offered to all existing, and any new referrals, to an adult psychological therapies team (PTT) in NHS Lanarkshire. Clinicians kept a record of the outcomes of these appointments over a six month period. Waiting times and attendance figures were compared before and after the introduction of the Signpost system.

Findings

Following the introduction of Signpost appointments, individuals were seen sooner for both assessment and therapy. Attendance at first appointments improved and Signpost appointments helped inform treatment planning. Although alternatives were discussed, the majority of clients were still offered individual therapy. Service user and staff satisfaction was high.

Practical implications

The results from this study led to assessment (“Signpost”) appointments being rolled out across other adult PTTs in NHS Lanarkshire.

Originality/value

There is little research looking at the impact of assessment/signpost appointments on adult mental health services in the UK. In the current climate of public service cuts, this study provides an innovative way of reducing waiting times and maintaining service user satisfaction, without requiring more resources.

Details

Mental Health Review Journal, vol. 23 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 15 March 2013

Kenneth J. Klassen and Reena Yoogalingam

Physician lateness and service interruptions are a significant problem in many health care environments but have received little attention in the literature. The purpose…

1211

Abstract

Purpose

Physician lateness and service interruptions are a significant problem in many health care environments but have received little attention in the literature. The purpose of this paper is to design appointment systems that reduce waiting times of the patient while maintaining utilization of the physician at a high level.

Design/methodology/approach

Empirical data from time studies and surveys of medical professionals from multiple outpatient clinics are used to motivate the study. Simulation optimization is used to simultaneously account for uncertainty and to determine (near) optimal scheduling solutions.

Findings

As lateness increases, it is shown that, in general, appointment slots should be shorter and pushed later in the session. Conversely, as interruptions rise, appointments in the middle of the session should be longer. These findings are fairly consistent over a variety of environmental conditions, including clinic sizes, service time variance, and costs of physician time compared to patients' time.

Practical implications

This paper demonstrates that the dome/plateau‐dome scheduling patterns that have been found in prior studies work well under many of the new factors modeled here. This is encouraging because it suggests that a generalizable pattern is emerging in the literature for the range of environments studied in these papers and this research provides guidance as to how to adjust the pattern to account for the factors studied here. In addition, it is shown that some environments will perform better with a different pattern, which the authors denote a “descending step” pattern.

Originality/value

This paper differs from most prior studies in that the complexity of environmental variables and stochastic elements of the model are simultaneously accounted for by the simulation optimization algorithm. The (very few) prior papers that have used simulation optimization have not addressed the factors studied here.

Details

International Journal of Operations & Production Management, vol. 33 no. 4
Type: Research Article
ISSN: 0144-3577

Keywords

Article
Publication date: 19 July 2011

Martyna Sliwa and James O'Kane

A recurring problem in the service quality literature is measurement – knowing which quality aspects should be measured and in what ways. This article aims to assess…

1415

Abstract

Purpose

A recurring problem in the service quality literature is measurement – knowing which quality aspects should be measured and in what ways. This article aims to assess service quality measurement by focusing on general practice appointment systems.

Design/methodology/approach

The authors use a case study, integrating qualitative and quantitative methods, including interviews with stakeholders as well as data regarding appointment systems' temporal aspects.

Findings

This study offers insights into service quality's subjective and context‐dependent nature, as reflected in primary healthcare stakeholder perceptions and service quality's objective and quantifiable aspects, revealing its dynamic, process‐based nature.

Research limitations/implications

The empirical approach to service quality measurement did not focus on all general practice service quality aspects, but instead focused on patient appointments with healthcare professionals. Broader applications to include other service quality aspects should be addressed by research.

Practical implications

Using one approach, service operators could have a tool for obtaining a more complex and richer service quality picture, leading to a better understanding of the relationship between service delivery and its evaluations by different stakeholders.

Originality/value

The service quality measurement method offers innovative insights into different theoretical abstractions, constructively challenges both measurement and service quality, whilst moving beyond managerial and user‐based approaches, and is highly relevant to contemporary organisation practice.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 June 1995

Chrwan‐jyh Ho, Hon‐Shiang Lau and Jing Li

The general practice in implementing an appointment scheduling rule(ASR) is to enforce a certain rule, such as “blockappointment”, to schedule customer arrivals in service…

1123

Abstract

The general practice in implementing an appointment scheduling rule (ASR) is to enforce a certain rule, such as “block appointment”, to schedule customer arrivals in service systems. There are several commonly used ASRs that have been used in such service systems as public and private clinics and restaurant reservations, most of which tend to minimize the idle time or optimize the utilization rate of the service facility while neglecting customers′ waiting times. One commonly used ASR in real‐world service systems, which schedules several customers to arrive at the start of each service session, tends to induce long customer waiting time, but manages to keep the facility idle time fairly low. Introduces an ASR to reduce customers′ waiting time considerably while increasing the facility idle time at a manageable minimum. Evaluates environmental factors that may affect the performance of ASRs, such as the probability of no‐shows, the coefficient of variation of service times, and the number of customers per service session. Discusses several exceptional situations such as walk‐ins, seasonality of customer arrivals, and multiple‐priority/queues.

Details

International Journal of Operations & Production Management, vol. 15 no. 6
Type: Research Article
ISSN: 0144-3577

Keywords

Article
Publication date: 28 September 2012

Yossy Machluf, Avinoam Pirogovsky, Elio Palma, Avi Yona, Amir Navon, Tamar Shohat, Amir Yitzak, Orna Tal, Nachman Ash, Michael Nachman and Yoram Chaiter

As part of the routine work of the medical committees in the Israel Defense Forces, a unique nationwide computerized control system is being implemented to assess and…

1114

Abstract

Purpose

As part of the routine work of the medical committees in the Israel Defense Forces, a unique nationwide computerized control system is being implemented to assess and manage medical processes. The purpose of this paper is to report on that implementation.

Design/methodology/approach

The computerized system consists of three main components: a specific status indicating the processes in each file, an appointment system, and an internal computerized system that uses a magnetic card for the regulation of the local waiting lists.

Findings

The combined computerized system improves the control and management of the medical processes and informatics from the point‐of‐view of both the patients and system operators. Different parameters of quality control regarding the medical and administrative processes are assessed (such as efficiency), and solutions are sought. Computerized system‐based design and re‐allocation of human and medical resources were implemented according to the capacities and limitations of the medical system. A reduction in the daily number of invited recruits improved the quality of the medical encounters. Specific combined status codes were introduced for the efficient planning of the medical encounters. Implementation and automation of medical regulations and procedures within the computerized system make the latter play a key role and serve as a control tool during the decision‐making process.

Originality/value

The computerized system allows efficient follow‐up and management of medical processes and informatics, led to a better utilization of human and medical resources, and becomes a component of the decision making by the system operators and the administrative staff. Such a system could be used with success in clinics, hospitals, and other medical facilities.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 January 2004

MATS EDENIUS and ALF WESTELIUS

There is an increasing interest in employing e‐mail or other Internet‐based messaging systems in communication between patients and healthcare professionals. Many projects…

Abstract

There is an increasing interest in employing e‐mail or other Internet‐based messaging systems in communication between patients and healthcare professionals. Many projects are put into practice, and numerous studies shed light on patients’ preferences regarding e‐messaging and their experience and use of e‐messaging. We argue in this paper that the conventional research in the field to some extent lacks a discussion about what kinds of knowledge an e‐messaging system generates among its users when it is put into practice. We suggest that placing the concept of knowledge as a discourse in focus, stressing how patients make judgements and distinctions in their use of e‐messaging, exposes important aspects not only regarding how patients relate to the system but also what e‐messaging in the healthcare sector means. We illustrate such a perspective with empirical material based on two focus groups of users of an e‐messaging system via a Swedish healthcare Web portal. Three kinds of knowledge formations are illuminated in this context: how patients develop knowledge by comparing e‐messaging services with traditional ways to contact healthcare; how the system generates a further demand for control by its users; and how the e‐messaging system helps users develop knowledge of the healthcare system in general.

Details

Journal of Human Resource Costing & Accounting, vol. 8 no. 1
Type: Research Article
ISSN: 1401-338X

Article
Publication date: 30 September 2013

Yu-Li Huang

The paper aims to provide a simulation optimization solution to improve patient scheduling that accounts for varying ancillary service time such as x-ray to minimize…

Abstract

Purpose

The paper aims to provide a simulation optimization solution to improve patient scheduling that accounts for varying ancillary service time such as x-ray to minimize patient wait time.

Design/methodology/approach

The two-step approach is to: identify patients' needs for ancillary services while scheduling appointments; and propose an algorithm to determine ancillary service time via simulation optimization. The main aim is to provide sufficient time between arrival at the clinic and the actual examination time for a patient to complete pre-visit activities without contributing significantly to patient wait time. Two case studies are included to demonstrate the approach.

Findings

Triaging at the appointment-scheduling time saves an average 17 minutes for physician's first consultation in a clinic day, and a 7 percent reduction on current average patient wait time for case 1. Case 2 results in a 9 percent reduction on average patient wait time. The scheduled ancillary service time depends on the frequency and the ancillary service time, and appointment slot design.

Research limitations/implications

One limitation is the impact of modeling error on the account of ancillary service times and the modeling assumptions.

Practical implications

The proposed approach provides a studying method for clinic staff to account for ancillary services prior to physicians' visits for a better patient care. Two case studies demonstrated the practicability and promising results on reducing patient waiting.

Originality/value

This article presents a unique approach to considering the required ancillary services in outpatient scheduling system that minimizes patient wait times. The approach will strengthen the existing scheduling methods to allow the time for ancillary services.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of over 21000