A simulation study of registration queue disciplines in an outpatient clinic: a two-stage patient flow model

The purpose of this study is to provide a guideline for designing a hospital's centralised registration process. This study examines the two-stage patient flow and how registration queue disciplines affect the performance of clinic idle time and patient waiting time. We first identify and evaluate six factors (no-show rates, the punctuality of patient arrivals, appointment schedule overlaps, block appointment, range of process variability among clinics and registration queue disciplines) that affect the process variability of patient flows. Second, we conduct a series of simulation experiments with three different queue disciplines: the Flow Rate (FR) rule (the proposed model), First-Come-First-Served (FCFS) and Earliest Due Date (EDD). The simulation results show that the proposed FR rule improves system performance significantly. [Received 22 December 2007; Revised 20 May 2008; Revised 21 July 2008; Accepted 2 August 2008]