Institute of Management, Operations Research, Ruhr University Bochum, Universitätsstr. 150, 44801 Bochum, Germany.
Institute for General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Int J Environ Res Public Health. 2023 Jan 18;20(3):1767. doi: 10.3390/ijerph20031767.
(1) Background: Workflows are a daily challenge in general practices. The desired smooth work processes and patient flows are not easy to achieve. This study uses an operational research approach to illustrate the general effects of patient arrival and consultation times on waiting times. (2) Methods: Stochastic simulations were used to model complex daily workflows of general practice. Following classical queuing models, patient arrivals, queuing discipline, and physician consultation times are three key factors influencing work processes. (3) Results: In the first scenario, with patients arriving every 7.6 min and random consultation times, the individual patients' maximum waiting time increased to more than 200 min. The second scenario with random patient arrivals and random consultation times increased the average waiting time by up to 30 min compared to patients arriving on schedule. A busy morning session based on the second scenario was investigated to compare two alternative intervention strategies to reduce subsequent waiting times. Both could reduce waiting times by a multiple for each minute of reduced consultation time. (4) Conclusions: Aiming to improve family physicians' awareness of strategies for improving workflows, this simulation study illustrates the effects of strategies that address consultation times and patient arrivals.
(1) 背景：工作流程是日常实践中的一个挑战。期望的顺畅工作流程和患者流程并不容易实现。本研究采用运营研究方法来阐明患者到达和咨询时间对等待时间的一般影响。
(2) 方法：使用随机模拟来模拟一般实践的复杂日常工作流程。根据经典排队模型，患者到达、排队规则和医生咨询时间是影响工作流程的三个关键因素。
(3) 结果：在第一个场景中，当患者每 7.6 分钟到达一次且咨询时间随机时，个体患者的最长等待时间增加到 200 多分钟。第二个场景中，患者随机到达且咨询时间随机，与按计划到达的患者相比，平均等待时间增加了 30 分钟以上。基于第二个场景调查了一个繁忙的上午时段，以比较两种减少后续等待时间的替代干预策略。这两种策略都可以将每减少一分钟咨询时间的等待时间减少若干倍。
(4) 结论：本模拟研究旨在提高家庭医生对改进工作流程策略的认识，阐明了针对咨询时间和患者到达的策略的效果。
