An assessment of the interruption level of doctors in outpatient appointment scheduling

Interruptions to the server in an outpatient clinic environment have received limited attention in the appointment scheduling literature. However, explicitly modeling interruptions on the part of the doctor may have an impact on the optimal appointment schedule and consequently, on patient waiting times. This is explored with a simulation optimization model that is based on data from time studies and interviews with medical professionals from multiple outpatient clinics. The results show a “plateau-dome” scheduling rule for practical implementation to be robust for low interruption rates and a traditional dome pattern for higher levels of interruptions. In addition, if clinic operations are such that doctors are able to adjust their behavior to complete all work during the session, then the schedule is invariant to changes in the interruption rate.