Integrated Optimization of Appointment Allocation and Access Prioritization in Patient-Centred Outpatient Scheduling

Abstract Walk-in patients can take a large portion of outpatient visits in comprehensive hospitals. In current common practice, an even number of appointments is assigned to each slot and patients with appointment are given a strictly higher priority than walk-in patients. As a result, walk-in patients usually wait longer and incur noticeable dissatisfaction. To improve their satisfaction, we propose an integrated optimization approach for patient-centred outpatient scheduling. This approach aims to allocate appointments in line with the temporal variation of patient walk-ins, and further develop a time-invariant threshold-based prioritization scheme to balance the service priorities between the two types of patients in real time. To substantiate this approach, we develop a prospect theory-based model to quantify each patient’s real-time satisfaction. We apply discrete-event simulation-based optimization to maximize the average patient satisfaction over the two types of patients. To verify our integrated optimization approach, we conduct a pilot in the endocrine department of Shanghai Sixth People’s Hospital. Our results suggest that our approach substantially decreases the waiting time of walk-in patients without much compromise on the satisfaction of patients who made advance appointment.