Using Simulation Optimization to Solve Patient Appointment Scheduling and Examination Room Assignment Problems for Patients Undergoing Ultrasound Examination

Design of an ultrasound appointment system based on a patient-centered real-time dynamic resource allocation strategy

INTRODUCTION

The existing ultrasound appointment system faces multiple challenges, including a lack of diversity in its operation modes, sluggish efficiency, and limited flexibility. During emergency situations, such as disease outbreaks or severe disaster events, the demand for ultrasound examinations skyrockets, making it imperative to offer patients efficient and user-friendly ultrasound appointment services.

METHODS

This study introduces the application of a patient-centered real-time dynamic resource allocation strategy in an ultrasound appointment system. This strategy focuses on the demand of patients, builds a multichannel and multimode ultrasound appointment system, and opens sets of parameters related to ultrasound appointments, such as examination room attributes, workload adjustments, and mutually exclusive rules of medical orders. The system can display patient appointment data in real time and carry out statistical analysis, and medical resources can be flexibly configured according to the patient appointment situation to fully meet the needs of patients. Moreover, the system interconnects the appointment data with the registration system and the examination room examination list to further optimize the medical service process.

RESULTS

Data such as the proportion of appointment channels, appointment time, and the quality and efficiency of ultrasound examinations before and after the introduction of the appointment system were compared and analyzed. According to the statistics, the proportion of online bookings increased from 0% to 81.42%. The average appointment times of general ultrasound examination and specialist ultrasound examination were reduced by 90.7% and 78.86%, respectively. The appointment staff was saved by 4 people, the average waiting time of patients in the examination area was reduced from 42 min to 11 min, and the number of ultrasound examinations was increased by 11.5%, while the number of error reports was also significantly reduced.

DISCUSSION

The results show that the application of this strategy in an ultrasound appointment system is feasible and efficient. Patients can participate more in the entire process of ultrasound appointment and examination, obtain reliable ultrasound medical services faster and more efficiently, improve the diagnosis and treatment environment and order of the hospital, and optimize the medical service process.

Analysis of factors affecting ultrasound examination time: A quantitative study

BACKGROUND

Numerous studies have focused on reducing patient absences and effectively scheduling exams. However, very few studies have analyzed the factors influencing examination time and predicted examination time.

OBJECTIVES

To investigate the factors affecting ultrasound examination visit length and provide a reference for interventions to optimize ultrasound appointments.

METHODS

This cross-sectional study was conducted at a fertility clinic in China. Ultrasound examination time and clinical characteristics were obtained from the electronic records. Univariate and multivariate analyses used 33,432 patients who attended our clinic center between August 1 and October 30, 2018. A quantile regression model was constructed to examine associations between ultrasound examination time and statistically significant variables in the univariate analysis.

RESULTS

Of the 33,432 patients included in this study, 29,085 (87%) were female and 4,347 (13%) were male. Their mean examination time was 6 ± 3 minutes. The doctor's title and gender, equipment, and patient's age, examination site, gender, and origin were all statistically significant. Physical examination and outpatient clinic patients had shorter examination times than inpatients. Female physicians had longer examination times than male physicians. Examination time was positively correlated with thyroid, breast, liver, gallbladder, spleen, pancreas, kidney, heart, vascular, adrenal, gynecological, early pregnancy, nuchal translucency, prostate, scrotum, and mid-to-late pregnancy fetal sites. Moreover, NT and mid-to-late pregnancy fetal sites showed a clear and continuous positive trend with increasing examination time.

CONCLUSION

The length of the ultrasound examination was correlated with the examination site, physician title, physician gender, patient age, patient gender, patient origin, and instrumentation. The reliability of inspection time predicted by variables such as the physicians' title, sex, sites examined, and the number of sites examined was higher when they were longer.

Exploring the perceptions of radiographers pertaining to the provision of quality radiological services in Zimbabwe

INTRODUCTION

Radiology is part of the service industry; therefore, there is a need to understand quality and its associated factors. The cost of poor service quality is a loss of competitive advantage, increased litigation, misdiagnosis, unnecessary radiation exposure, and patient mortality. There has been little research into the factors influencing the quality of radiological services in Zimbabwe. This work, therefore, aimed to explore the radiographer's perceptions of the factors that affect the quality of radiological services at central hospitals in the Harare Metropolitan Province.

METHODS

A qualitative, explorative study applying the SERVQUAL model was carried out. One-on-one interviews with 10 purposively sampled radiographers employed at central hospitals in the Harare Metropolitan Province were conducted. The data were managed by Nvivo 12 (QSR International) and analyzed by framework analysis.

RESULTS

Radiographer's perceptions of the factors that affect the quality of radiological services were categorized by five themes namely; i. Tangibles - the physical appearance of the radiology department and facilities, ii. Reliability and dependability - the ability to perform the promised service dependably and accurately, iii. Responsiveness - the willingness to help patients and provide prompt service, iv. Assurance - the knowledge and courtesy of radiology staff and their ability to inspire trust and confidence, and v. Empathy - caring, the individualized attention the radiology department provides to its patients.

CONCLUSION

Economically viable, well-designed national strategies are needed to prioritize and fund radiology in Zimbabwe and other resource-constrained settings. Recognition of acquired specialist skills by radiographers to halt the exodus and training of radiologists, radiology nurses, medical physicists, and biomedical engineers by local institutions will go a long way in improving the quality of radiological services.

Patient Unpunctuality's Effect on Appointment Scheduling: A Scenario-Based Analysis

This study examined patient unpunctuality's effect on patient appointment scheduling in the ultrasound department of a hospital. The study created a simulation system incorporating the formulated F3 distribution to describe patient unpunctuality. After the simulation model passed verification and validation processes, what-if scenarios were conducted under two policies: The preempt policy and the wait policy. A comparison of the total cost of each policy showed that the preempt policy performed better than the wait policy in the presence of unpunctuality. The study used sensitivity analyses to identify the different effects of patient unpunctuality on the system. The weights of the cost coefficient of both radiological technician's idle time and patient waiting time must be equal in order to achieve a lower cost. The patient's inter-arrival time must be close to the average total time in the system to achieve lower costs. Moreover, utilization decreases as the patient's inter-arrival increases. Therefore, the patient's inter-arrival time should be higher than, but close to, the service time to ensure less radiological technician's idle time and patient waiting time.

Analysis of Patient Satisfaction through the Effect of Healthcare Spending on Waiting Times for Consultations and Operations

In recent years, public authorities have invested large amounts of public money in trying to reduce waiting times for consultations and operations with the aim of improving the quality of the healthcare system. Our research aims to analyze the effect of these investments on patient satisfaction through the mediating relationship of waiting times for consultations and operations, as well as from a gender perspective. By studying a series of key indicators of the Spanish healthcare system and applying partial least squares structural equation modelling (PLS-SEM), the findings show that the model explains 12.10% of the variance in consultant waiting times, 51.90% in operation waiting times, and 27.00% in patient satisfaction. We found that increased public spending leads to increased patient satisfaction by reducing waiting times. However, no gender-based differences were found. The results provide exciting implications for theory and practice, indicating how policymakers can orient their strategies towards improving patient satisfaction.

Applying Simulation Optimization to Minimize Drug Inventory Costs: A Study of a Case Outpatient Pharmacy

Drug inventory management is an important part of hospital management. The large amounts of drug data in hospitals bring challenges to optimizing the setting values for the safety stock and the maximum inventory of each drug. This study combined a two-stage clustering method with an inventory policy (s, S) and established a simulation optimization model for the case hospital’s outpatient pharmacy. This research used the simulation optimization software Arena OptQuest, developed by Rockwell Automation Inc (Rockwell Automation, Coraopolis, PA, USA), in order to determine the minimum and maximum values (s, S) of the best stock amounts for each drug under the considerations of cost and related inventory constraints. The research results showed that the minimum and maximum inventory settings for each drug in the simulation model were better than those set by the case outpatient pharmacy system. The average inventory cost was reduced by 55%, while the average inventory volume was reduced by 68%. The proposed method can improve management efficiency and inventory costs of hospital pharmacies without affecting patient services and increasing the inventory turnover rate of the drugs.