An application of discrete-event simulation to an outpatient healthcare clinic with batch arrivals

An application of discrete-event simulation is performed on an unique outpatient primary care clinic serving a military population at Fort Sill, OK. Access to the clinic is on an exclusively walk-in basis. Arrivals occur primarily in batches; arrival times and batch sizes are stochastic in nature. The nursing and medical staffs available each day also follow a stochastic process. The arrival process is characterized through discrete distributions. Several alternatives are modeled to examine procedural changes that may result in improved patient flow and provider utilization. A hybrid appointment/walk-in model was determined to have the best promise for improvement, but the possible benefits it may yield do not seem to justify the costs of its implementation in this setting. Possible applications of the hybrid model to other facilities such as urgent care facilities are discussed.