musyiokines

Healthcare Scheduling

Lateka Payne

Liberty University

February 13, 2022

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Abstract

Healthcare scheduling aims to ensure robust allocation of the necessary healthcare

resources that will assist healthcare facilities in meeting the needs. On the other hand, patient

appointment scheduling involves various activities, including planning when the patient visits the

facility to confirm that all the important resources are available. Healthcare appointment

scheduling has witnessed a wide variety of alterations that are currently shaping the face of this

department, enabling it to become better and better. The report highlights the important role of

appointment scheduling in guaranteeing positive patient outcomes. It plays the lead role in

ensuring the patient will receive the ultimate care they need with the available resources. This

study aims to discuss the factors that must be considered in implementing healthcare scheduling

and the impacts of effective and efficient scheduling in improving patient care.

Research Questions

1. What factors should be taken into consideration when formulating healthcare scheduling?

2. How does efficient and effective patient appointment scheduling influence patient

outcomes" Is the association positive and negative?

3. Do organizations improve healthcare scheduling impact within the healthcare

organization?

Introduction

Approximately 15% of the total gross of the United States is represented in the healthcare

industry. The expenditures in healthcare are growing at such a rate that the amount of money

required to finance healthcare is currently standing at 45% of all spending in healthcare (Daknou

et al., 2012). By 2050, the amount is expected to have doubled. Some Americans, especially

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those covered by employers sponsored, have expected double premiums as a staff is shifting to a

greater and better portion of rapidly increasing healthcare costs to the workers. Suppose various

factors such as increasing demand for chronic care, aging population, strained public and private

care budgets to this mix. In that case, there is increased pressure on health services providers to

enhance efficiency. Appointment scheduling is in between the intersection of efficiency and

timely access to health facilities. Convenient access needs to realize good medical outcomes.

Also, it determines the development of patient satisfaction. There are a variety of factors that

determines the ability to provide timely access, such as fundamental questions about which type

and how many physical assets and gear are a health system should invest in, how it should

allocate resources between various sites, how are the appointments planned, and how should

staff each hospital or clinic site. This study aims to discuss the factors that must be considered in

implementing healthcare scheduling and the impacts of effective and efficient scheduling in

improving patient care.

Literature Review

The healthcare industry has many technological advances towards scheduling for patients

and healthcare staff. The availability of these advances can decrease by various patient

dissatisfaction such as patient quality care, patient wait time, and patient satisfaction rate

(Benatyeb et al., 2019). The patient waiting time is reduced by models of patient appointment

scheduling and maximizes the usage of resources, healthcare providers, equipment's and staff

while the access to care is expanded. Some barriers can be created by the non-automated forms

of scheduling and challenge the patient while making efforts to obtain healthcare services from

having trouble accessing the health organization scheduler, limited appointment available, long

phone waiting time, and lack of healthcare providers. Most healthcare institutions adopt

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electronic scheduling, running on the computer platform that utilizes and generates information

to produce flexible, efficient scheduling formats. The United States spends more than 18% of its

total gross domestic product on healthcare (Gur and Eren, 2018). High cost is among the

significant problems faced in the United States system, which regularly does not translate

healthcare quality.

Healthcare costs rise each year, and greater efforts need to be introduced to cut costs and

ensure that all patients have cost-effective healthcare services despite awareness being available.

Patients' inappropriate use of emergency services can be increased by long delays in scheduling

systems, which increases healthcare expenses. Often, patients cannot receive benefits when in

need. The emergency rooms are their first source of care services. The issues of using emergency

sectors to seek non-urgent matters or life-threatening are their costs. More than twenty million

visits to the emergency department, where approximately two-thirds of emergency doctors are

avoidable. Some conditions can be treated in and managed in the primary care setting (Gur and

Eren, 2018). The treating cost in the emergency department is higher than the general healthcare

provider's offices. Some patients use the traditional scheduling system to plan for appointments

and face difficulties getting a position in the emergency sectors may appear as their only hope.

Some conflicts may arise because of the traditional patient scheduling. Service eminence and

competence, healthcare cost, the productivity of the healthcare staff, and patient results and

outcomes may be impacted. To implement a more actual and effective patient scheduling system,

efforts must be made to ensure patients are offered the best care possible, especially acute and

chronic patients. This ensures that the total cost of care is controlled to avoid adding to the

growing cost of care. The emergency department should not be relied on as their form of care; it

is the responsibility of the healthcare organizations to introduce and adopt the current scheduling

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system to ensure patients are receiving the best care (Hall, 2012). Organizations using the

traditional scheduling system must conduct analysis and collect data to understand the negative

effects caused to the patients and the entire healthcare in general. There will be a better effort

through current scheduling to minimize the curb on inappropriate use of emergency rooms and

extra steps to start modern healthcare practices to offer the essential care services for the patients.

Healthcare institutions must recognize any possible signs of using a traditional scheduling

system and guarantee that patients can receive the best services possible. Organizations that lean

on the Lord for guidance and discernment can implement the most active scheduling system to

ensure that they can enlarge care access.

Methodology

The research used a qualitative research method through questionnaires as the data

collection tool. The research participants were medical practitioners who were randomly picked

from three clinics. Their roles were to provide insights into the various factors that should be

considered when formulating healthcare scheduling and the impacts of effective scheduling on

patient outcomes and overall facility outcomes.

Results

This section will focus on analyzing the study's outcomes, including various aspects such

as how effective and efficient patient appointment scheduling will play an integral role in

improving the consequences of the patients (Boone et al., 2022). Other topics discussed in this

section include the factors taken into consideration when implementing patient scheduling in

health care, the impacts of effective and efficient patient scheduling, and their impacts on overall

healthcare.

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Social Demographic profiles of respondents

The social demographic variables include sex, age, and education. The study will focus

on these three aspects because the intervention takes in highly professional institutions and will

thus focus on only acquiring the necessary information.

Age of Respondent

Age is the duration of time that different respondents have had in their lifespan. The table below

illustrates the age of the individuals used in the study.

Classification Age

Female 20 – 55

Male 23 = 65

4.1.2. Respondent’s age and gender

Gender is the aspect that differentiates the respondents from a biological perspective. The table

below illustrates the genders of the respondents used in the study.

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The pie chart illustrates that most of the study respondents were female, occupying 64 percent,

while the male respondents constituted 34%. The age and gender evaluations were carried out to

determine the gender and age of the respondents that can perceive the importance of patient

scheduling to boost patient outcomes.

. Respondents' level of education.

The respondents' level of education is carried out to determine the respondents' highest level of

educational qualifications.

Female Male

Gender of Respondents in %

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As expected, it is clear from the above illustration that the majority of the nurses within the

health facilities were highly qualified individuals who have vast knowledge in understanding

how patient scheduling would benefit healthcare while boosting patient outcomes at the same

time. Conducting an educational background played an integral role in promoting the validity of

the research.

Factors to be taken into consideration when developing healthcare scheduling

Appointment Intervals

85% of the respondents agreed that appointment intervals were an important aspect

healthcare practitioners consider when implementing appointment scheduling. The participants

pinpointed that their health facilities schedule patients at different intervals such as 10, 15, or 20

minutes manually or through the computer system (Azadeh et al., 2015). They also added that

depending on the type of appointment the patient was needed, the health facilities tend to

schedule more than one block. For instance, the healthcare facilities use a 10-minute interval for

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Diploma Degree Other Qualification

No. of Respondents

No. of Respondents in %

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patients who need their blood pressure checked, while a new patient can be provided with a

schedule of three ten-minute intervals. According to the participants, establishing a basis where

patient appointments are based on a break has played an integral role in making it easy for

practitioners to conduct physical examinations and special procedures instead of routine follow-

ups with patients.

Physicians' needs and preferences

76% of the respondents agreed that considering the needs and preferences of the

physician is important in the implementation of a reliable scheduling program. In connection to

this, the practitioners highlighted that sometimes the physician might need to conduct physical

examinations or surgical procedures at a particular time and a precise number of times per day

(Hall, 2019). According to the nurses, there are certain times when the physician might need to

conduct other tasks such as performing hospital rounds to ensure that the admitted patients are

doing well or paying nurse-home visits. Therefore the patients end up getting locked out. The

medical practitioner may also need to take lunch breaks and catch up with other physicians

(Huang, 2016). As a result, considering this aspect into the practice is important in enabling

patients to have appointments when it is convenient for the practitioner to boost the quality of

health outcomes.

Healthcare amenities and equipment requirements

Another variable that significantly impacted healthcare scheduling is the availability of

equipment and facilities in the setting. 89% of the respondents agreed that healthcare scheduling

should be based on equipment availability, such as the necessary machines in the examination

rooms (Kanakoglu et al., 2020). The participants agreed that it is important for one or two

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physicians to meet patients whenever the facility is open for optimal utilization of resources. As

a result, this plays an integral role in improving the efficiency and time administration for seeing

patients.

Impacts of effective and efficient scheduling on patient outcome

The participants agreed that implementing effective and efficient patient scheduling has

created many positive relationships, especially boosting patient outcomes. For instance, effective

and efficient scheduling has played an integral role in reducing missed appointments, managing

referrals, and improving patient engagement and access due to the extension of appointment

scheduling hours. Reliable scheduling has also played the integral role of enabling practitioners

to deliver timely reminders to patients and follow-ups, which is critical to improving the rate of

recovery and reducing hospital readmissions.

Impacts of patient scheduling on healthcare

92% of the nursing professionals pinpoint that effective and efficient patient scheduling

has had meaningful impacts on healthcare outcomes. For instance, a lot of scheduling is done

through computers which provides these organizations with ideal opportunities that they can

explore to improve the productivity levels of the nurses by providing them with ample time to

relax to avoid burning out, which increases the risk of medical errors (Kuo et al., 2020).

Automatic scheduling aims to boost the match between the different healthcare resources,

including nurses, examination rooms, medicines, doctors, and a high rate of responding to patient

needs. This is because a reliable scheduling system focuses on minimizing waits for patients

while at the same time amplifying the usage of key resources by tracking the available resources

while accurately predicting future demand for medical services. Also, 85% of the respondents

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highlight that patient scheduling plays an integral role in enabling hospitals to save money which

they can use to implement an ideal ideology that they can use to invest in a scheduling program.

81% of the respondents support the fact that computerization of the appointment

scheduling system has reduced the number of commuting patients as the majority of appointment

scheduling can be done remotely. This has resulted in the individualism of healthcare (Lee and

Lee, 2020). This has also reduced the number of patients waiting in line, allowing nurses to have

a conducive environment to produce positive patient outcomes. However, some participants were

quick to point out that automation of patient scheduling is a beneficial adventure, although many

caregivers are still suffering from the deficiency of developing better resources that will focus on

fulfilling the patient's needs (Pool et al., 2019). From this regard, the individual placed in the

managerial position is the one who does not have skills in engineering or organizational training.

As a result, the healthcare facility lacks the relevant sophistication that will assist in delivering

efficiency to patients.

Discussion

The results reveal that various key factors should be considered when implementing a

healthcare scheduling system. One of these factors includes appointment interval, which ensures

that the medical practitioners will set adequate time to respond to the needs of the patients and

their personal needs (Saure et al., 2020). Therefore, scheduling appointments in intervals of 10,

15, or 20 minutes is highly important in ensuring that patients can participate at that given time

to improve their health outcomes. Also, other factors influence healthcare schedules, including

facilities and material requirements and physicians' needs and preferences. All these aspects

should be paid attention to to guarantee a quality working environment for the patients.

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The results illustrate that appointment scheduling has attracted positive impacts by

boosting patient outcomes and the nursing practice. For instance, appointment scheduling has

helped create patient engagement where patients can comfortably book appointments through

their mobile phones instead of waiting in the queue (Nasir and Dang, 2018). Also, the meeting is

high because the patients play the main role in developing the health goals they would want to

accomplish and follow up with the medical practitioners to ensure that they understand the

measures they can take to achieve their goals. Additionally, it has helped improve patient

outcomes due to the quality care provided in the facility, which has also diminished the rates of

readmission. Alternatively, healthcare facilities have been positively impacted by this move

(Munavalli et al., 2020). From the results section, it is clear that they have helped reduce

employee burnout by shifting the majority of services to online platforms where patients can

keep track of their appointments and medications. As a result, the nurses have a lot of quality

time they can use to improve the health outcomes of the admitted patients more satisfactorily.

Apart from that, the results further identify that the benefits of patient scheduling are not

employed by some organizations mainly because the management is not educated enough to

understand the program's benefits (Luscombe and Kozan, 2016). Therefore, the study developed

numerous that will enable these hospitals and other facilities that were not selected to participate

in the survey to identify the various ways through which they can use to boost the quality of

patient scheduling in their organization. The first strategy is to leverage technology to ensure that

the patient will receive timely messages or emails reminding them of their upcoming

appointment. Therefore, the main goal for managers, in this case, would be to ensure that their

healthcare facilities have automated texting that functions by sending notifications and providing

an opportunity for the patient to ask questions that they may be having (Vermeulen et al., 2012).

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Automated notifications include a wide variety of options such as "cancel," "confirm," and

"reschedule (Qu et al., 2012)." It should also boost transparency by informing the patients on

things such as cancellation fees and policies to help in reducing no-shows.

The management should prioritize the implementation of patient-based scheduling based

on the urgency of the medical appointment they need. The reason for this is that healthcare needs

tend to vary with speed. Therefore, higher priority should be assigned to patients in critical

conditions such as chronic illnesses by scheduling the same day (Regan-Smith, 2012). Other

conditions that should not be prioritized include allergies or side effects developing from

consuming certain types of medications. The patient can be educated on the remedies they can

adopt at home or through online consultation. Healthcare should also maintain an active waiting

list, which effectively reduces the impacts of cancellations and no-shows. Notifications can be

dispatched to the patients informing them of vacant slots that have opened up so that those who

need to come in early for their appointments can reduce missed appointments. Also, unfilled

positions can be advertised for those who need to fill in same-day appointments that arise within

the day.

Apart from that, appointment scheduling can be made more effective and efficient by

keeping a tight record of trends such as identifying the patient who tends to cancel their medical

appointments frequently and finding out why they are adopting this behavior. This is important

in understanding the measures employed to create assignments that suit their convenience

(Wojtys et al., 2012). Also, the patients can be provided with time slots that they can use to

preschedule their selections up to a time convenient for those who have a habit of canceling at all

times, especially postponing a few minutes before. Tracking such information is important in

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enabling the practitioner to make the necessary steps to reduce waiting times, improve care

quality and abolish bottlenecks that tend to hinder the excellence of care.

Another recommendation is to opt for visit duration, where a standard wellness criterion

is used to allocate more time to patients with adverse medical conditions while administering less

time to the patients who do not need urgent care (Valizadeh et al., 2020). Create patient

scheduling services such as fixing appointments, including eligibility verification of the

insurance and development of personal accounts. Streamlining these services is highly important

in optimizing the healthcare cycle administration. Healthcare facilities should be rewarded with a

broad range of professionals who will ensure that the patient appointment scheduling is managed

to enable the facility to gain patient trust, boost the productivity of the nurses, and bring a

positive impact on the revenue cycle.

Conclusion

As a concluding remark, it is clear from the above illustrations that patient scheduling

using computers is more beneficial than the traditional mode of scheduling which was mainly

based on written records. As a result, many patients would miss important appointments,

preventing them from accomplishing their health goals. However, automatic scheduling brings

great paybacks to the patient outcome by boosting engagement and reducing the readmission

rate. The appointments provide patients with key information that they can follow to avoid

relapsing to the same illness. It is also evident that some hospitals are lagging in implementing

this program. However, implementing the above steps in the discussion will play an integral role

in creating a flexible healthcare system interconnected by positive relationships.

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References

Abdalkareem, Z. A., Amir, A., Al-Betar, M. A., Ekhan, P., & Hammouri, A. I. (2021).

Healthcare scheduling in optimization context: A review. Health and Technology, 11(3),

445-469.

Azadeh, A., Baghersad, M., Farahani, M. H., & Zarrin, M. (2015). Semi-online patient

scheduling in pathology laboratories. Artificial intelligence in medicine, 64(3), 217-226.

Bentayeb, D., Lahrichi, N., & Rousseau, L. M. (2019). Patient scheduling based on a service-

time prediction model: a data-driven study for a radiotherapy center. Health care

management science, 22(4), 768-782.

Boone, C. E., Celhay, P., Gertler, P., Gracner, T., & Rodriguez, J. (2022). How Scheduling

Systems with Automated Appointment Reminders Improve Health Clinic

Efficiency. Journal of Health Economics, 102598.

Daknou, A., Zgaya, H., Hammadi, S., & Hubert, H. (2012, February). A dynamic patient

scheduling at the emergency department in hospitals. In 2010 IEEE workshop on health

care management (WHCM) (pp. 1-6). IEEE.

Gür, Ş., & Eren, T. (2018). Application of operational research techniques in operating room

scheduling problems: A literature overview. Journal of Healthcare Engineering, 2018.

Hall, R. W. (2012). Handbook of healthcare system scheduling. New York: Springer Science+

Business Media, LLC.

Huang, Y. L. (2016). The development of patient scheduling groups for an effective appointment

system. Applied clinical informatics, 7(01), 43-58.

16

Kandakoglu, A., Sauré, A., Michalowski, W., Aquino, M., Graham, J., & McCormick, B. (2020).

A decision support system for home dialysis visit scheduling and nurse routing. Decision

Support Systems, 130, 113224.

Kuo, Y. H., Balasubramanian, H., & Chen, Y. (2020). Medical appointment overbooking and

optimal scheduling: tradeoffs between schedule efficiency and accessibility to

service. Flexible Services and Manufacturing Journal, 32(1), 72-101.

Lee, S., & Lee, Y. H. (2020, June). Improving emergency department efficiency by patient

scheduling using deep reinforcement learning. In Healthcare (Vol. 8, No. 2, p. 77).

Multidisciplinary Digital Publishing Institute.

Luscombe, R., & Kozan, E. (2016). Dynamic resource allocation to improve emergency

department efficiency in real-time. European Journal of Operational Research, 255(2),

593-603.

Munavalli, J. R., Rao, S. V., Srinivasan, A., & van Merode, G. G. (2020). Integral patient

scheduling in outpatient clinics under demand uncertainty to minimize patient waiting

times. Health Informatics Journal, 26(1), 435-448.

Nasir, J. A., & Dang, C. (2018). Solving a more flexible home health care scheduling and routing

problem with the joint patient and nursing staff selection. Sustainability, 10(1), 148.

Pool, E. T., Poole, K., Upjohn, D. P., & Hernandez, J. S. (2019). Agile project management

proves effective, efficient for Mayo Clinic. Physician Leadersh J, 34-8.

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Sauré, A., Begen, M. A., & Patrick, J. (2020). Dynamic multi-priority, multi-class patient

scheduling with stochastic service times. European Journal of Operational

Research, 280(1), 254-265.

Qu, X., Rardin, R. L., Williams, J. A. S., & Willis, D. R. (2012). Matching daily healthcare

provider capacity to demand in advanced access scheduling systems. European Journal

of Operational Research, 183(2), 812-826.

Regan-Smith, M., Young, W. W., & Keller, A. M. (2012). An efficient and effective teaching

model for ambulatory education. Academic Medicine, 77(7), 593-599.

Valizadeh, S., Fatahi Valilai, O., & Houshmand, M. (2020). Flexible flow line scheduling

considering machine eligibility in a digital dental laboratory. International Journal of

Production Research, 58(21), 6513-6531.

Vermeulen, I. B., Bohte, S. M., Elkhuizen, S. G., Lameris, H., Bakker, P. J., & La Poutre, H.

(2012). Adaptive resource allocation for efficient patient scheduling. Artificial

intelligence in medicine, 46(1), 67-80.

Wojtys, E. M., Schley, L., Overgaard, K. A., & Agbabian, J. (2012). Applying lean techniques to

improve the patient scheduling process. Journal for Healthcare Quality, 31(3), 10-16.