Title: Simulating the effects of access improvement strategies in an outpatient memory clinic with high follow-up volumes

Authors: Esmaeil Bahalkeh; Tze C. Chiam; Yuehwern Yih; James M. Ellison

Addresses: University of New Hampshire, Durham, NH 03824, USA ' UConn School of Medicine, Department of Pediatrics, Hartford, CT 06106, USA ' Purdue University, West Lafayette, IN 47907, USA ' Alzheimer's Center, Thomas Jefferson University, Phildaelphia, PA 19144, USA

Abstract: Demand for treatment services related to neurocognitive disorders such as dementia is growing due to the aging of our population, increased life expectancy, and the high prevalence of cognitive symptoms. These services are often provided by outpatient memory clinics. In the studied outpatient memory clinic, average monthly demand and average patient wait times to receive their first evaluation increased by five folds and three folds between 2011 and 2017. In this paper, we investigated clinic's operations and identified overbooking, repatriation - referring stable follow-up patients from specialty care to primary care - and increasing provider slots as potential strategies to improve access and long wait time issues. We then evaluated their effectiveness using an empirical simulation-optimisation model. Our results suggest that despite increasing wait times in the clinic, increasing provider slots is not always an effective strategy. In fact, overbooking and repatriation can result in more significant performance improvements.

Keywords: wait time; access; outpatient memory clinic; overbooking; discrete event simulation; repatriation.

DOI: 10.1504/IJSPM.2023.138583

International Journal of Simulation and Process Modelling, 2023 Vol.20 No.4, pp.276 - 285

Received: 28 Oct 2023
Accepted: 04 Jan 2024
Published online: 13 May 2024 *

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