Studying nurse workload and patient waiting time in a hematology-oncology clinic with discrete event simulation

ABSTRACT

Our study is performed in a hematology-oncology clinic in Québec. This clinic experienced a 20% increase for hematology treatments and a 131% increase for oncology treatments. Clinic managers and personnel felt that this increase led to higher patient waiting time and personnel workload. Clinic managers decided to examine the possibility of adding resources to alleviate nurse workload. Patient trajectories and lead times, appointment scheduling and nurse workload are analyzed with a discrete-event simulation model. It is shown that patient waiting time is not too long. A nurse overload problem is observed with a nurse occupancy rate of 86.98% in the morning and 64.48% in the afternoon. New schedule appointments taking into account nurse capacity are proposed. These result in a decrease of the difference in nurse occupancy rates in the morning and in the afternoon.

KEYWORDS:

• Nurse workload
• patient waiting time
• appointment scheduling
• discrete-event simulation
• design of experiments
• work sampling
• value-added and non-value-added tasks
• outpatient hemato-oncology clinic