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Indiana University Bloomington

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Journal Articles

The Impact of Variability and Patient Information on Healthcare System Performance

2011, Production and Operations Management

Kurt Bretthauer, P. Salzarulo, M. Cote, K. Schultz

Abstract

In the delivery of health care services, variability in the patient arrival and service processes can cause excessive patient waiting times and poor utilization of facility resources. Based on data collected at a large primary care facility, this paper investigates how several sources of variability affect facility performance. These sources include ancillary tasks performed by the physician, patient punctuality, unscheduled visits to the facility's laboratory or X-ray services, momentary interruptions of a patient's examination, and examination time variation by patient class. Our results indicate that unscheduled visits to the facility's laboratory or X-ray services have the largest impact on a physician's idle time. The average patient wait is most affected by how the physician prioritizes completing ancillary tasks, such as telephone calls, relative to examining patients. We also investigate the improvement in system performance offered by using increasing levels of patient information when creating the appointment schedule. We find that the use of policies that sequence patients based on their classification improves system performance by up to 25.5%.

Citation

Salzarulo, P., K. Bretthauer, M. Côté, and K. Schultz (2011), "The Impact of Variability and Patient Information on Healthcare System Performance," Production and Operations Management, Vol. 20, No. 6, November/December, pp. 848-859.