Improving Services to Hospital Outpatient Clinics

摘要

The waiting time from referral to actual appointment to see a specialist doctor at the outpatient clinic is often long, can be many months. It is challenging to manage the number of patients from the waiting list whom can be seen with respect to retaining sufficient capacity to follow-up existing patients. The situation is often worse if some of the patients have to revisit clinic many times or, in some cases, throughout their lifetime. This study demonstrate how system dynamics can be used as an insightful strategic planning tool for an outpatient clinic to manage the increasing demands due to the constrained capacity and capability. An outpatient system dynamics model was built according to the principles of system dynamics. The simulation model includes the operational parameters as measures of capacities. A number of impact areas are identified and proposed to test the effectiveness of the model. Key indicators were set to enable the validation and evaluation of the proposed interventions. All the scenarios have been simulated 1000 times to generate a mean result for the validation. The model suggested that creating specialist clinic and patient orientated follow-up system would improve services to the outpatient clinics. Given the recommended interventions, the model generates an accurate prediction of outcomes. Following this intervention with the surgical outpatient services, the model has been used interactively with nearly all the outpatient services in the organisation. The model provides accurate forecasting scenarios that are validated with post-intervention data. It supports the service implementing the intervention with the consideration of system delays and provides a balanced solution to avoid any short-term or long-term disruption.