Lanes, clusters, sightlines: Modelling patient flow in medical clinics

Sailer, Kerstin; Utley, Martin; Pachilova, Rosica; Fouad, Ahmed Tarek Zaky; Li, Xiaoming; Jayaram, Hari; Foster, Paul J.

Abstract

Lengthy waiting times for ophthalmology appointments in the UK’s National Health Service (NHS) increased with the COVID-19 pandemic, necessitating a different approach to triaging patients safely and swiftly. Moorfields Eye Hospital NHS Trust therefore opened an additional clinic designed with a linear spatial layout and patient flow system, which is analysed in this paper in comparison with an existing clinic. By integrating direct observations of patient flows and an architectural layout analysis based on space syntax methods with queuing simulations from operational research, the results indicate that each clinic operates in line with its spatial logic and has its advantages and disadvantages. The newly opened clinic with a lane system supports flows and coordination through sightlines between stations, whereas the existing clinic with clusters of stations compensates by enabling a more organic flow, especially in conjunction with experienced technicians, which is beneficial when the clinic becomes busy. When high patient load is simulated in the queuing model, lanes result in slightly bigger bottlenecks and longer clinic durations. An ideal allocation of the number of stations to diagnostic activities based on clusters is suggested. This work contributes to combined architectural and operations research and the understanding of routines as performative.

• Journal Article Type: Article
• Acceptance Date: May 3, 2025
• Online Publication Date: May 26, 2025
• Publication Date: May 26, 2025
• Deposit Date: Jun 2, 2025
• Publicly Available Date: Jun 3, 2025
• Journal: Buildings & Cities
• Print ISSN: 2632-6655
• Electronic ISSN: 2632-6655
• Publisher: Ubiquity Press
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 1
• Pages: 201–218
• DOI: https://doi.org/10.5334/bc.545
• Public URL: https://uwe-repository.worktribe.com/output/14534423