Improving patient satisfaction and outpatient diagnostic center efficiency using novel online real-time scheduling

Abstract

We develop a novel online real-time scheduling algorithm with applications for healthcare diagnostic centers to deal with walk-in patients based on a set of constraints on the sequence of tests and resources. The problem is especially significant at healthcare centers in developing and emerging nations, such as India, where appointment schedules do not work. Within this realistic context, our objective is to improve patient satisfaction by reducing waiting time and improve diagnostic center performance through better utilization of the constrained resources. We propose a Mixed Integer Linear Programming (MILP) formulation to represent diagnostic centers as a Flow and Open Shop, to capture the system dynamics of the Flexible Hybrid Shop Scheduling Problem. We then develop a novel Online Genetic Algorithm (OGA) capable of solving real life large scale problems, as Open Shop scheduling problems are NP-hard. The developed OGA is first validated for small instances against a theoretical lower bound and the MILP model using CPLEX solver for flow time and makespan. The OGA is then empirically validated with data collected from two diagnostic centers of different sizes and configurations. For both centers, the developed OGA shows significant improvement compared to the simulation model. This research offers an important contribution to both literature and practice as it is one of the first to model the patient scheduling problem as an online real-time process. Implementing the developed OGA would help diagnostic centers significantly improve time estimates, thus reducing actual patient time and improving the efficiency of the system. Most importantly, the OGA is generalizable beyond healthcare to a broad range of environments that share Hybrid Shop characteristics.