A Simulation Study of the Negative Effects of the Single Block Appointment System in Specialist Outpatient Clinics of a Tertiary Healthcare Institution

Abstract

This paper is concerned with the investigation of the negative effects of the Single Block Appointment System via a simulation study of queues in selected specialist outpatient clinics of a tertiary healthcare Institution. The single block appointment system is presently in use in the specialist outpatient clinics of the tertiary healthcare Institutions in Nigeria. This work has being able to model and study the existing single block appointment system via simulation in other to reveal its negative effects on the queue performance measures namely; average waiting time of patients, average number of patients in queue, doctor’s utilization and additional time spent by doctors after clinic closed. Two specialist outpatient clinics of the Federal Medical Centre Makurdi Nigeria have being selected for the simulation study. These include the Paediatrics and Surgical, clinics. The result across the clinics shows that the single block appointment system causes long waiting time of patients, shortens idle time for doctors with the tendency of over utilization. It does not allow for the determination of the optimal number of appointments within the six (6) hours clinic duration. The reason been that the additional time spent by doctors after clinic closed, increases as the number of appointment increases.