Managing Appointment-Based Services in the Presence of Walk-in Customers

Despite the prevalence and significance of walk-ins in healthcare, we know relatively little about how to plan and manage the daily operations of a healthcare facility that accepts both scheduled and walk-in patients. In this paper, we take a data-analytics approach and develop an optimization model to determine the optimal appointment schedule in the presence of potential walk-ins. Our model is the first known approach that can jointly handle general walk-in processes and heterogeneous, time-dependent no-show behaviors. We demonstrate that, with walk-ins, the optimal schedules are fundamentally different from those without. Our numerical study reveals that walk-ins introduce a new source of uncertainties to the system and cannot be viewed as a simple solution to compensate for patient no-shows. Scheduling, however, is an effective way to counter some of the negative impact from uncertain patient behaviors. Using data from practice, we predict a significant cost reduction (42%–73% on average) if the providers were to switch from current practice (which tends to overlook walk-ins in planning) to our proposed schedules. Although our work is motivated by healthcare, our models and insights can also be applied to general appointment-based services with walk-ins. This paper was accepted by Gad Allon, operations management.