An Empirical analysis of queuing practices in relation to patient satisfaction at the Outpatient Department of Teaching Hospital Kalutara

Abstract

A waiting line or a queue is a common phenomenon, particularly where the demand for a service exceeds its supply. However, an operations research technique commonly known as queueing theory is now widely used in many applications of optimizing operations that deal with this mismatch. Waiting, which is known to cause patient dissatisfaction is a common occurrence in public healthcare settings. However, it is not only the waiting that brings dissatisfaction to the patients but also the other factors such as quality of care, consultation time, rapport with physicians, and physical environment of the settings, etc. A descriptive cross-sectional and analytical study was designed and carried out at the outpatient department of Teaching Hospital Kalutara, with data collected primarily through an interviewer-administered questionnaire and an observation chart over a two-week period. This study attempted to describe the level of satisfaction of patients in terms of their socio-demographic characteristics, frequency of visiting, perceived waiting for service, perceived speed of service, and perceived serving time. The associations between socio-demography, perceived waiting, and satisfaction were found significant. However, the associations between the perceived speed of service, perceived serving time, and the level of satisfaction were not significant. Having identified the queuing system that complies with exponentially distributed inter-arrival times and serving times in the presence of multiple servers (M/M/c queuing model) as an appropriate model to analyze the queuing system of the outpatient department of Teaching Hospital Kalutara, it was observed that the system has been heavily overutilized. The results of the parameter estimates were challenged by the fact that the arrival rates of the system often exceeded the rate of serving. The simulation results indicated that about twenty-eight physicians are therefore needed to serve during rush hours if the expected standards of care were to be achieved. However, having a large number of serving physicians at once is not an appropriate solution in terms of operational, administrative, and financial feasibility. Therefore, an appointment system to schedule the arrival process, and to deploy an appropriate number of physicians resolute through M/M/c simulation-based modeling, which should essentially carry the standard criterion for service rate, is recommended to achieve better patient satisfaction by optimizing care at the outpatient department of Teaching Hospital Kalutara.