Health Systems

, Volume 6, Issue 1, pp 77–89 | Cite as

Rapid diagnoses at the breast center of Jeroen Bosch Hospital: a case study invoking queueing theory and discrete event simulation

  • Maartje van de VrugtEmail author
  • Richard J. Boucherie
  • Tineke J. Smilde
  • Mathijn de Jong
  • Maud Bessems
Case Study


When suspected tissue is discovered in a patient’s breast, swiftly available diagnostic test results are essential for medical and psychological reasons. The breast center of the Jeroen Bosch Hospital aims to comply with new Dutch standards to provide 90% of the patients an appointment within three working days, and to communicate the test results to 90% of the patients within a week. This case study reports on interventions based on a discrete time queueing model and discrete event simulation. The implemented interventions concern a new patient appointment schedule and an additional multi-disciplinary meeting, which significantly improve in both the appointment and diagnostics delay. Additionally, we propose a promising new patient schedule to further reduce patient waiting times and staff overtime and provide guidelines for how to achieve implementation of Operations Research methods in practice.


breast cancer outpatient clinic intervention study queueing theory discrete event simulation 



We would like to thank all involved JBH staff for their input and cooperation during this project. Additionally, the authors thank two anonymous referees for their valuable comments.


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Copyright information

© The OR Society 2016

Authors and Affiliations

  • Maartje van de Vrugt
    • 1
    • 2
    • 3
    Email author
  • Richard J. Boucherie
    • 1
  • Tineke J. Smilde
    • 2
  • Mathijn de Jong
    • 2
  • Maud Bessems
    • 2
  1. 1.Center for Healthcare Operations Improvement and Research (CHOIR)University of TwenteEnschedeThe Netherlands
  2. 2.Breast center Jeroen Bosch Hospital’s HertogenboschThe Netherlands
  3. 3.University of TwenteEnschedeThe Netherlands

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