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Paediatric Orthopaedic Clinic Case

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Using Simulation Modeling to Improve Patient Flow at an Outpatient Orthopedic Clinic

Thomas R. Rohleder, PhD Division of Health Care Policy and Research Mayo Clinic 200 First Street SW Rochester, Minnesota 55905 tel: 507-538-1532 Email: rohleder@mayo.edu Peter Lewkonia, MD Faculty of Medicine University of Calgary Calgary, Alberta Diane Bischak, PhD Haskayne School of Business University of Calgary Calgary, Alberta Paul Duffy, MD Faculty of Medicine University of Calgary Calgary, Alberta Rosa Hendijani Haskayne School of Business University of Calgary Calgary, Alberta

July 2011

Abstract We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced.

Keywords: Outpatient Clinic, Discrete Event Simulation, Process Improvement, Patient Waiting

I.

Introduction Visiting hospital outpatient clinics is a very common way for patients to

access health care. These clinics typically schedule appointments for patients in advance, and patients arrive to the clinic expecting service to begin at their scheduled time. However, due to the patient arrival time and service time variation described in Noon, Hankins, & Cote [1], patients end up waiting even though they have reserved time slots. Further, it is common

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