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Iran Red Crescent Med J. 2013 Sep;15(9):865-9. doi: 10.5812/ircmj.7908. Epub 2013 Sep 5.

Reducing outpatient waiting time: a simulation modeling approach.

Author information

  • 1Department of Health Services Management, Mother and Child Health Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran ; Clinical Research Center, Milad Hospital, Tehran, IR Iran.
  • 2School of Management Science and Medical Information, Tehran University of Medical Sciences and Health Services, Tehran, IR Iran.
  • 3College of Industrial Engineering, Iran University of Science and Technology, Tehran, IR Iran.



The objective of this study was to provide a model for reducing outpatient waiting time by using simulation.


A simulation model was constructed by using the data of arrival time, service time and flow of 357 patients referred to orthopedic clinic of a general teaching hospital in Tehran. The simulation model was validated before constructing different scenarios.


In this study 10 scenarios were presented for reducing outpatient waiting time. Patients waiting time was divided into three levels regarding their physicians. These waiting times for all scenarios were computed by simulation model. According to the final scores the 9th scenario was selected as the best way for reducing outpatient's waiting time.


Using the simulation as a decision making tool helps us to decide how we can reduce outpatient's waiting time. Comparison of outputs of this scenario and the based- case scenario in simulation model shows that combining physician's work time changing with patient's admission time changing (scenario 9) would reduce patient waiting time about 73.09%. Due to dynamic and complex nature of healthcare systems, the application of simulation for the planning, modeling and analysis of these systems has lagged behind traditional manufacturing practices. Rapid growth in health care system expenditures, technology and competition has increased the complexity of health care systems. Simulation is a useful tool for decision making in complex and probable systems.


Outpatients, Patients; Simulation

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