A simulation study of scheduling clinic appointments in surgical care:: individual surgeon versus pooled lists

The purpose of this paper is to compare two methods of scheduling outpatient clinic appointments in the setting where the availability of surgeons for appointments depends on other clinical activities. We used discrete-event simulation to evaluate the likely impact of the scheduling methods on the number of patients waiting for appointments, and the times to appointment and to surgery. The progression of individual patients in a surgical service was modelled as a series of updates in patient records in reaction to events generated by care delivery processes in an asynchronous fashion. We used the Statecharts visual formalism to define states and transitions within each care delivery process, based on detailed functional and behavioural specifications. Our results suggest that pooling referrals, so that clinic appointments are scheduled with the first available surgeon, has a differential impact on different segments of patient flow and across surgical priority groups.