The Impact of Variability and Patient Information on Health Care System Performance
Article first published online: 14 DEC 2010
© 2010 Production and Operations Management Society
Production and Operations Management
Volume 20, Issue 6, pages 848–859, November/December 2011
How to Cite
Salzarulo, P. A., Bretthauer, K. M., Côté, M. J. and Schultz, K. L. (2011), The Impact of Variability and Patient Information on Health Care System Performance. Production and Operations Management, 20: 848–859. doi: 10.1111/j.1937-5956.2010.01210.x
- Issue published online: 15 NOV 2011
- Article first published online: 14 DEC 2010
- History: Received: June 2006; Accepted: September 2010 by Aleda Roth, after 3 revisions.
- health care operations;
- service operations management;
- appointment scheduling
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%.