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

Komal Aqeel Safdar; Ali Emrouznejad; Prasanta Kumar Dey

摘要

Purpose - 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. Design/methodology/approach - 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. Findings - 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. Originality/value - 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.

机译：目的 - 本研究的目的是开发队列评估模型，以评估在没有预约系统的繁忙公立医院的繁忙公立医院中的步入门诊的流入，并建立一个专门展现实用的动态框架实施拟议模型，用于持续监控队列系统。设计/方法/方法 - 目前的研究利用数据包络分析（DEA）开发应用于评估患者的等待时间，在综合军医医院（CMH）的门诊部门的不同阶段内的等待时间在巴基斯坦拉合尔，七周（4月23日至2014年5月28日）。医生/人员和咨询时间的人数被视为产出，咨询时间是非自由裁量权产出。两个输入是等待时间和队列的长度。此外，Excel中的VBA编程已被利用来开发用于连续队列监控的动态框架。调查结果 - 观察人员可用性不足是长度等待时间的关键问题，以及过度拥挤和可变的步入患者到达模式。 DEA模型显示了“必需的”人员数量，对应于不同的等待时间，指示队列积累。原创性/价值 - 目前的研究为公共医院的繁忙门诊部门开发了队列评估模型，其中“所有”患者是步入式和无预约系统。该模型以“所需”的形式提供了重要信息，该人员数量允许管理员可以控制队列先发制人最小化等待时间，具有最佳但动态的员工分配。此外，动态框架专门针对持续队列监测的新兴经济体的资源贫困公立医院的实际实施。

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

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