Simulator X

Outpatient Clinic - Service Management & Queuing Simulation

The simulation story: SGH is a community out-patient clinic located in the city of Kochi, in the southern state of Kerala, India. It had 3 specialities - General Checkup (Govt. approved), Ob-Gyn and Dental. SGH was run by a team of 3 in-house doctors, one for each speciality supported by a triage. There were 4 appointment slots available at the clinic: Morning (8 - 10 AM), Forenoon (10 AM - 1 PM), Afternoon (2PM - 4 PM), and Evening (4PM - 7 PM). The demand for appointments at the clinic varied during the week. It was observed that the number of patients seeking appointments were generally higher near the weekends (Monday, Tuesday, Saturday), and lower during mid-week. Patients often preferred the morning and evening slots, as they could consult the doctor before or after work, without having to take a day off. Some of the doctors were also allowed to take outside appointments in other hospitals (during mid-day hours) for consulting and surgical practice. The in-house Ob-gyn specialist also had a registered license for performing General Checkups.

SGH offered a value proposition of quality, affordable care with a fast turnaround time. The service levels at SGH stipulated patient waiting time (to meet the doc) upon arrival as preferably less than 15 minutes, but no more than 25 minutes.

The consultation time at SGH varied for specialities, but was generally in the range of 30-40 minutes. Dental surgeries took about 2 hours. The service turnaround for patients who sought consulting appointments was kept as 1 hour, from the time of patient arrival at the clinic. This was found to be attractive to many patients who otherwise had to wait long for appointments elsewhere, and had to take a day off to consult a doctor. It was seen that post-covid, SGH experienced a higher patient load. And, the triage faced a challenge in scheduling the appointments and also meeting the service standards of waiting time and turnaround time. SGH had a 4 cabin capacity, 2 that could be used interchangeably for General and Obgyn consulting, and 2 for dental practice. Recently, SGH had made arrangements with some reputed doctors, who were willing to practice part-time for Ob-gyn and dental specialties. A majority of the consultations (about 80 percent or more) were by appointments only, with some walk-ins especially for emergency cases.

Instructions to the Student:
1. As a consultant, you are tasked to improve the service management at SGH.
2. You have to make decisions on triaging (scheduling), demand and capacity management for day-to-day service operations.
3. Note that an increase in waiting time or turnaround time beyond the stipulated levels leads to customer dissatisfaction.
4. The doctors' time is also at a premium, and to be efficiently utilized, mitigating idle time, and preventing ineffective scheduling.
5. You have to optimize scheduling the appointments for efficiently running the clinic, and high patient satisfaction levels.