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Optimisation of Patient Flow and Scheduling in an Outpatient Haemodialysis Clinic
Abstract
The demand for renal replacement therapy (RRT) from the growing number of patients suffering from chronic kidney disease (CKD) and end stage renal disease (ESRD) in Nigeria is reported to be on the rise. However, dialysis clinics are few with limited facilities to meet the increasing demand leading to congestion, long waiting time and increased length of stay (LOS) in dialysis clinics. This paper presents an optimisation model for scheduling patient flow in an outpatient haemodialysis clinic. The objective is to minimize patient LOS using Genetic Algorithm (GA), implemented in Python programming language with Spyder Integrated Development Environment (IDE). The model was tested using data obtained from a haemodialysis clinic, in Lagos, Nigeria. The model generated optimum LOS values (193.01, 275.02 and 390.01) minutes compared to the mean LOS values at the haemodialysis clinic (235.50, 296.62 and 424.50) minutes for the 3-hour, 4-hour and 6-hour dialysis sessions. Furthermore, a simulation experiment of patient flow in a typical haemodialysis clinic was performed by gradual variations in patient arrival rates, λ. Simulation results at (λ=0.1,0.2,0.3,0.4) revealed mean LOS (minutes) as (312.85 ± 73.45, 348.18 ± 84.89, 342.18 ± 81.30, 305, 28 ± 63.67) respectively. The optimisation model was effective in reducing patient LOS.