A general multi-stage queuing system
model with patients’feedback
flow is developed to address the behavior of patients’ flow in an Outpatient
Department (OD) in a hospital. The whole process includesregistration, diagnosis, chemical
examination, payment, and medicine-taking. Focusing on nurse resources, the
formulas of performance indicators such as patientwaiting times and nurse idle timesare derived by using the system
parameters. A mathematical programming model is developed to determine how many
nurses should be allocated to each stage to minimize the total costs of patient
waiting times and nurseidle times. The neighborhood search combined Simulated Annealing (NS-SA)
is developed to solve the model, which is essentially a natural number
decomposition problem. Numerical experiments are conducted to analyze the
discipline of nurse allocation and the impact of patientarrival rates and the probability of
patient’s feedback flow on the system costs. The research results will be
managers to make decisions on allocation of nurse staff in practice.
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