Rolling horizon appointment scheduling: a simulation study.

Health-care consumers continue to be frustrated with long waits, especially when an appointment has been made. However, providers who book appointments are under increasing pressure to maximize utilization so that revenues will be increased and costs reduced. Thus, scheduling appointments involves opposing forces that are difficult to manage. This challenge is addressed in a rolling-horizon environment with fluctuating demand loads. These two issues have not been explored previously in the appointment-scheduling research. Two management policies are considered: overload rules (OLR) and rule delay (RD). The former considers different scheduling methods (overtime, double booking) when demand loads are high, and the rule delay policy considers when to implement the overload rules. These methods are explored for six different demand patterns/loads and evaluated with a variety of client and server-oriented measures. The results show that managers of appointment scheduling systems must carefully consider which measures are most important to them since the best choices of OLR and RD vary substantially by measure. Good choices also depend on the general type of client demand pattern. Thus, to consider the various tradeoffs between client and server measures a matrix is developed that outlines good choices for each scenario.