The objective governing our study poses the potential for a solution that streamlines the patient scheduling process, creating a system such that patients and infusion clinics are both better off. Consequently, our objective weighting scheme aims to decrease the wait times of patients while uniformly distributing the workload of nurses from week to week.
Upon gathering and analyzing the data of a typical infusion center, a discrete-event simulation was created to model the queuing processes involved in the operation of the clinic, from initial patient scheduling to actual patient arrival, treatment, and departure. After ensuring the simulation accurately models the operations of the infusion center, the system parameters, namely the scheduling capacities of each day of the week, were adjusted to optimize the experience of patients and the workload of the nurses. In order to simplify reality, we posed the following assumptions for our model:
- Pharmacy has all required pharmaceuticals and a supply sufficient to meet demand
- Insurance is cleared for each patient prior to patient arrival
- Medical doctors are available to service all patients arriving
- Every patient receiving treatment needs blood work regardless of treatment type
- The number of treatments for each patient varies between one and seven following the discrete distribution below:
- Patient types were categorized into four main groups including: infusion (1), chemotherapy-short (2), chemotherapy-long (3), follow-up (4), and miscellaneous (5). These patient types followed the discrete distribution:
- Activity wait times were based on subjective shadowing experience of an infusion center
- Nurses and chairs/beds are the only resources affecting workflow; 20 chairs/beds are available and 8 nurses are always staffed
- Patient identification was not tracked throughout the entire system
- Patients can be scheduled anytime during the day excluding weekends; a 24/7 scheduling platform is assumed available for the infusion center and scheduling physician
- Patient experience is better off when nurses have a balanced work schedule, i.e., patient experience and nurse workload are not competing objectives
- The simulation runs Monday through Friday, weekends excluded
The aforementioned assumptions were necessary to reduce the complexity of implementing a realistic model of an infusion center’s scheduling process in a time sensitive manner.