Managing clinic variability with same-day scheduling, intervention for no-shows, and seasonal capacity adjustments

Abstract

This study investigates demand and capacity strategies for managing clinic variability. These include (i) same-day scheduling to control random walk-ins, (ii) no-show intervention, where the clinic calls advance-booked patients a day before to identify and release cancelled slots to same-day patients, and (iii) adjustments to daily number of appointments for advance-booked patients to match seasonal variations in same-day demand. These strategies are tested over the individual-block/fixed-interval (IBFI) and the Dome appointment rules. Our results show that choosing the appropriate refinements in the order of appointment rules, same-day scheduling, no-show intervention, and capacity adjustment provides maximum improvement. The total cost benefit of demand strategies (i) and (ii) is 7 to 21%, whereas the benefit of capacity strategy (iii) is as high as 6%. Our study affirms the universality of the Dome rule to perform well when combined with the demand and capacity strategies across different environments.