Improving the efficiency of physical examination services

Abstract

The objective of our project was to improve the efficiency of the physical examination screening service of a large hospital system. We began with a detailed simulation model to explore the relationships between four performance measures and three decision factors. We then attempted to identify the optimal physician inquiry starting time by solving a goal-programming problem, where the objective function includes multiple goals. One of our simulation results shows that the proposed optimal physician inquiry starting time decreased patient wait times by 50% without increasing overall physician utilization.

Fig. 1

The PE service framework

Fig. 2

The transient behavior of patient wait times via the histograms of the 1st, 5th, 11th and 20th patients under the original policy. x-axis: wait time in minutes. y-axis: frequency (a–d)

Fig. 3

Four performance measures as functions of physician inquiry starting time (pist). p _u: mean physician utilization; E(D): mean total service time for the physician inquiry; E(W): patient mean wait time; P(W > 150): patient prolonged wait rate (a–d)

Fig. 4

Four performance measures between the original and staggered registration policies (a–d)

Fig. 5

Simulated and two meta-models (Note: Quadratic models provide some infeasible values) (a–d)

Fig. 6

A framework of solutions, measures, decision variables, and methods for clinic services