A queueing network analysis of a health center

Abstract

This paper shows how a queueing network model helped to uncover the causes of delay in a health center appointment clinic. Patients, clerks, technicians, doctors and nurses agreed that the clerical registration area was the major bottleneck in the system. Our first reaction was to simulate the system with special attention on the complex registration procedure. Time constraints on data collection and program development led us to a queueing network model and QNA, a software tool for analyzing queueing networks developed by Whitt. The queueing analysis showed the registration area was not the bottleneck and we conjectured that delays were due to scheduling problems. A preliminary trial in the clinic of a modified appointment system showed promise with a 20 minute reduction in average time in the system (based on a small sample). Although there were significant differences between features of the real system and assumptions in the queueing network model, the queueing network model yielded insight into the operation of the appointment clinic.