Keeping a Steady Flow

How would you describe the behavior of patient flow in a physician’s waiting room?

SM. Patient flow in the doctor’s waiting room behaves less like an orderly queue and more like a cloud, from which patients need to be called according to complex logic.

This cloud is made up of different types of cases, including people admitted based on first‐come‐first‐served; patients with appointments who take priority, assuming they arrived on time; patients who are too late for their appointment (and whose priority might somehow still precede random walk‐ins); patients who walk in and got prioritized based on level of urgency (possibly by a triage nurse); patients who previously visited the doctor, got sent to a series of lab tests, and now come back with results; and so on.

Specific clinics often have other particular types of cases with unique behavior. For instance, patients visiting an ophthalmologist might be asked to wait 20 minutes for dilation to take effect, and then be called to the doctors according to their original order of arrival.


What are the basic tools used in such a system?

SM. The basic tools are LCD screen displays (replacing the old LED signs that only show the ‘next in line’ number). LCD displays provide enough room to show a number of different queues (such as appointments, walk‐ins, returning patients, and so on) and to show more than one patient per queue. All patients can see where they are on the display, and can feel relaxed knowing there's a consistent method at work.

For patients who will need to experience a long wait, more advanced options can be offered – for instance, to wait at a nearby cafeteria and be notified using SMS when they need to get back to the waiting room. The bottom line is, clinic patient flow is one complex challenge where good automated technology can make people (patients and doctors alike) more happy and relaxed than any human intervention – as well intended as it may be – ever could.


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