Finding
Across thirty holdout simulations, the selected policy books all urgent requests within one business day and all routine requests within seven. Under the assumed visit and staffing costs, incremental contribution versus first-come-first-served is −$53,600.
Why it matters
Review urgent and routine access together with staffing, attendance and unbooked demand. A shorter average wait does not establish that a policy is affordable or ready for clinical use.
Who could use this
Outpatient scheduling and operations leaders reviewing urgent and routine booking policies.
Data and scope
Synthetic requests, administrative urgency labels, no-show probabilities and staffing assumptions. No patient data or clinical predictions are used.
How the analysis works
Paired booking simulations use common random streams, ten development replications for policy selection and thirty separate holdout replications. Capacity audits, unbooked requests and arrival/absence stresses retain operational constraints.
Limits of the evidence
The results are conditional simulation outcomes, not clinical effectiveness or observed revenue. Assumed advance knowledge of capacity lost to absence is optimistic. Continuity, patient preferences and real staffing distributions need prospective validation.