DESIGN AND IMPLEMENTATION OF APPOINTMENT

MANAGEMENT SYSTEM

(A CASE STUDY OF Federal Medical Center (FMC).)

CHAPTER ONE

1.1 BACKGROUND OF THE STUDY

Appointment scheduling systems are used by primary and

specialty care clinics to manage access to service providers,

as well as by hospitals to schedule elective surgeries. Many

factors affect the performance of appointment systems

including arrival and service time variability, patient and

provider preferences, available information technology and

the experience level of the scheduling staff. In addition, a

critical bottleneck lays in the application of Industrial

Engineering and Operations Research (IE/OR) techniques.

The most common types of health care delivery systems are

described in this article with particular attention on the

factors that make appointment scheduling challenging. For

each environment relevant decisions ranging from a set of

rules that guide schedulers to real-time responses to

deviations from plans are described. A road map of the

state of the art in the design of appointment management

systems is provided and future opportunities for novel

applications of IE/OR models are identified.

Appointment Management system is a desktop application

that is designed to help fix schedule and appointment from

the management of organization and the customers, send

messages to customers either by phone or email. With this

computerized system there will be no loss of record or

member record which generally happens when a non -

computerized system is used. It is designed with web app

and the database used is MySQL Server xampp.

1.2 STATEMENT OF THE PROBLEMS

 There are problems found in appointment which include:

 An increase in the waiting time for appointments

 Frustration for customers, patients and staff
 A waste of valuable resources

1.3 MOTIVAION OF STUDY

The motivation of this study is to help patients easily book

appointments and to reduce waiting issues which may

arise as a result of inadequate time management from

the clinic, not knowing what their faith is till they

come to the clinic.

1.4 OBJECTIVE OF THE STUDY

The project aims and objectives that will be achieved after

completion of this project are discussed in this subchapter.

The aims and objectives are as follows:

• To resolve Contact issue.

• To Request column for creating new appointment.

 • To view appointment list.

1.5 PURPSOE OF THE STUDY

The purpose of the study is to reduce the time wasted in
waiting for appointments, also patients spend resources in
trying to transport their selves and eventually don’t get to
meet with their appointments they booked for, causing
frustration that would be bridged by this study.

1.6 SCOPE OF THE STUDY

This research work will concentrate on creating new

appointment, and other details will be viewed for entry by

the student as the case may be, with a case study of

Federal Medical Center (FMC)

1.7 SIGNIFICANCE OF THE STUDY

The significance of this study is to help and give benefits to

students, staff and school management of knowing what

appointment system is all about and the problems found in

appointment.
1.8 ORGANIZATION OF THE WORK

1.9 DEFINITION OF TERMS

 FMC: Is an abbreviation which stands for Federal

Medical Center (FMC)

 Appointment: an arrangement to meet someone at a

particular time and place. E.g.: "she made an

appointment with my receptionist".

• Management: It is the co-ordination of all the

resources of an Organization through the process of

planning, Organization, directing and controlling

• System: Physical component of a computer that is

used to perform certain task.

• Data: Numbers, Text or image which is in the form

suitable for Storage in or processing by a computer, or

incomplete information.
• Information: A meaning full material derived from

computer data by organizing it and interpreting it in a

specified way.

• Input: Data entered into a computer for storage or

processing.

• An emergency is a situation that poses an immediate

risk to health, life, property, or environment.

• Output: Information produced from a computer after

processing.

• Information System: A set of interrelated components

that collect (or retrieve), process, store and distribute

information to support decision making and control in

an organization.

• COMPUTER:-Computer is an electronic device that

accepts data as Input, processes data and gives out

information as output to the user.

• SOFWARE:-Software is set of related programs that

are designed by the manufacturer to control the

hardware and to enable the computer perform a given

task.

• HARDWARE: - Hardware is a physical part of a

computer that can be touched, seen, feel which are

been control by the software to perform a given task.

• DATABASE: - Database is the collection of related

data in an organized form.

• PROGRAMMING: - programmingisa set of coded

instruction which the computers understands and

obey.

• TECHNOLOGY: -Technology is the branch of

knowledge that deals with the creation and use

technical and their interrelation with life, society and

 the environment, drawing upon such as industrial art,

engineering, applied science and pure science.

• Algorithm: A set of logic rules determined during the

design phase of a data matching application. The

‘blueprint’ used to turn logic rules into computer

instructions that detail what step to perform in what

order.

• Application: The final combination of software and

hardware which performs the data matching.

• Data matching database: A structured collection of

records or data that is stored in a computer system.

• Data cleansing: The proactive identification and

correction of data quality issues which affect an

agency’s ability to effectively use its data.

 • Data integrity : The quality of correctness,

completeness and complain with the intention of the

creators of the data i.e ‘fit for purpose’.

CHAPTER 2: LITERATURE REVIEW

2.1 INTRODUCTION

The appointment module is an electronic paperless

application designed with high flexibility and ease of usage,
implemented in single clinics and polyclinics. The system
serves in managing appointments for different resources.
The resource can be any clinic or service, such as an
Ophthalmology clinic or X-ray apparatus. Each resource
has a defined daily schedule that indicates the available
time slots for booking appointments.
The appointments system is a means for E-health care
that allows for quick booking and managing of patients
appointments while eliminating the possibility of reiteration
of the same time slot for different patients. Only eligible
people with access permittance are consent to reserve
appointments, thereby to provide the best service for
patients. Specific objectives include:
1- Establishment of a paperless environment
2- Scheduling of the medical activities and services within
the healthcare center
3- Optimizes utilization of medical resources at the medical
center
4- Increase efficiency of medical care outcome
The function of the application includes:
 On-line booking and reservation of Appointments
 Pop up explanations when putting the mouse on a
certain function
 Access is permitted to authorized staff of the respective
healthcare center
 Statistical data generation pertaining to invariable
parameters
 Integration with the Master Patient Index (MPI)
 Integration with the Clinician System
 Keyboard use for data entry is minimized,
compensated by a drop-down list
 Search engine is available
 Arabic support is included for all user functions

2.1. Overview of Appointment Scheduling

Based on the health service required by patients,
appointment can be divided into
three main categories: primary care clinic, specialty clinic
and surgery appointment
scheduling (Gupta & Denton, 2008).
2.1.1. Primary Care Clinic Appointment
For primary care practices, the initial care is provided by a
single physician or a small group of physicians for families
when they faced medical problems. For a
multi-physician clinic, when making appointments for
patients, patients’ preferred
time slots and physicians should be taken into
consideration as well as physicians’
availability. The efficiency of clinic and patients’
satisfaction could be improved if a patient can be assigned
to a preferred time slot and physician who is familiar with
patients’ medical history. Two method of making primary
care appointments including advance-schedule, which
means patients called a given day before, or, for same-day
schedule, which means patients called to schedule an
appointment. The number and length of available
appointment time slots are various based on the type of
service request, medical urgency and providers’ panel (a
group of patients that has designated the same provider).

2.1.2. Specialty Care Clinic Appointment

For specialty care clinics, they focus on diagnoses,
treatment and recovery for some specialties such as
cardiology, neurosurgery and Endocrinology. Some related
tests or exams are provided to complete diagnoses or
treatments, but they are not achieved by surgical
techniques. Sometimes specialists require a referral from a
primary care physician or other specialist for patients’ first
appointment. The length of available appointment time
slots is fixed for most of services. When making
appointments for patients, the availability of examination
facilities, such as MRI and Scans, should be taken into
consideration as well.

2.2. Considerations of Appointment Scheduling

The goal of appointment scheduling is to provide an
optimal policy and achieve a
good balance between patients’ satisfaction and the
performance of providers or
clinics. In the real world, some factors will have influence
on the performance of an appointment system, such as
punctuality and urgency of patients, no-shows or
cancellations, and service process. Thus, when developing
a well-designed appointment system, the following main
factors should be taken into consideration
(Cayirli & Veral, 2003).
2.2.1. Unpunctuality
Unpunctuality of patients means the difference between
patients’ arrival time and
actual appointment time. Nuffield Trust studies (1955)
implied that more than half of the patients arrive early,
which could cause the congestion of the patient’s waiting
room and increase patients’ waiting time. Wijewickrama &
Takakuwa (2008) discussed how the impact of no-shows on
patients’ waiting time is higher than that of punctuality.
Contrary to this result, Blanco White & Pike (1964) showed
that the punctuality did not greatly affect performance of
appointment systems. In addition, some studies also
discussed unpunctuality of physicians as well, in which
physicians were late for the first appointment. Vissers
(1979) pointed out patients’ waiting time and physicians’
idle time were affected by the unpunctuality of both
patients and physicians.
2.2.2. No-shows and Late Cancellations
Some patients are late for their appointments as mentioned
in 2.2.2, and some patients miss their appointment as well.
This results in a patient no-show problem, which increases
underutilization of clinic capacity. Generally, 5-30% is used
as a no-show probability in past studies (Ho and Lau, 1992
& 1999; Klassen and Rohleder, 1996; Yang, Lau and Quek,
1998; Cayirli, Veral, and Rosen, 2006 & 2008; Kaandorp
and Koole, 2007). Some papers analyzed real data from
clinics and pointed out that patients with relatively high
no-show probability are younger, male, unmarried,
uninsured, with psychosocial problems, of lower
socioeconomic status, divorced or widowed and have a
history of missed appointments (Neal, Hussain-Gambles,
Allgar, Lawlor, and Dempsey, 2005). Daggy et al. (2010)
pointed out transportation and appointment lead time
affected the no-show probability as well. Similarly, some
papers implied that long appointment lead times increase
the no-show rate. Dove and Schneider (1981), Lee et al.
(2005) and Gallucci et al. (2005) reported that no-shows
were the most influential factor on performance of AS
among three environmental factors reviewed (Ho and Lau,
1992). To reduce no-show probability, changing patient
behavior or applying overbooking and short lead-time
scheduling are suggested (Daggy, etal., 2010).
2.2.3. Preferences of Patients
It has been shown that the accommodation of patients’
preferences can help ensure
quality of service provided by primary clinic physicians and
increase clinics’ revenues (O’hare and Corlett 2004). The
no-show rate can also be reduced if patients’ preferences
are matched.
2.2.4. Arrival Characteristics
2.2.4.1. Size of Arrival Units
A single arrival is only one unit, the smallest number
handled, that arrive at the
system and wait for service, typically a single patient. A
batch arrival is several units entering the system at the
same time. In this situation, the time between successive
arrivals of the batches may be probabilistic as well as the
number of customers in a batch.

2.2.5. Service Characteristics

2.2.5.1. Number of Services
As mentioned before, appointment scheduling is one type
of queuing process, so there are two types of queuing
stages, including single-stage and multi-stage. Single stage
means only one type of service requested when a patient
visits the clinic, while multi-stage means a series of
branched services may be required in the whole service
process. Most papers focus on a single-stage system.

2.2.5.2. Number of Physicians

In queuing theory, queuing systems can be divided into
single-server and multiple
systems. Physicians are servers in the health care system.
In primary care clinics,
especially in a multi-physician clinic, physicians have their
own panels. Similarly,
when scheduling a specialty care clinic and surgery
appointments, different physicians are required based on
the different services required by patients. In these cases,
appointment systems are multi-server systems. When
studying the performance of an appointment system, multi-
server systems are taken into consideration in some papers
such as Wijewickrama & Takakuwa, (2008) and Chao et.al
(2003).

2.2.5.3. Service Time

The service time can be random or constant. It can be
assumed that the service time of routine appointment at
primary care clinic is constant. On the other hand, surgery
time is based on the types of surgery and physical
conditions of patients, so service time is randomly
distributed. Generally, random service time for surgeries is
often modeled by a negative exponential probability
distribution (Gross D. and Harris M. ,1985).

2.2.5.4. Queue Discipline

The queue discipline is applied to determine the priority
order for patients to be
scheduled for an appointment. According to general
queuing theory, queue
discipline is divided into four main classes, FCFS (first
come, first serve), LCFS (last come first served), SIRO
(service in random order), and PR (priority ranking). In the
appointment scheduling problem, it is assumed that
patients are served FCFS in most of papers. In the real
world, some clinics apply a priority ranking discipline when
they scheduling appointments. For example, clinics give
the first priority to emergent patients and second priority to
readmission patients. Walk-in patients are usually given to
the lowest priority.

2.3. Measurements of an Appointment System’s

Performance
Cayirli and Veral (2003) provided a comprehensive
summary of the performance
measurement such as patients’ waiting time, providers’
overtime and idle time, and
the corresponding cost/penalty.

2.3.1. Cost-Based
Costs of patients’ waiting time and physicians’ idle time
and overtime are three factors when studies focus on
minimizing the cost of appointment cost. In most of cases,
costs of patients’ waiting time and physicians’ idle time are
the main considerations, such as in Vanden Bosch, Dietz
and Simeoni (1999), Lau and Lau (2000), Robinson and
Chen (2003).

2.3.2. Time-Based
Patient’s waiting time and flow time, and physician’s idle
time and overtime are
measured in terms of mean, maximum, variance and
frequency distribution. In general, it is assumed that
patient’s waiting time is the difference between the
scheduled appointment time and patient’s actual service
start time, but waiting time due to early arrival of the
patient is not taken into consideration. Patient’ flow time is
the total time patient’ spent in the clinic. Physician’s idle
time is defined as the waiting time caused by no patients
waiting to be seen. Overtime time is the difference between
actual and planned finish time of consults. Some papers
studied the appointment system problem with time-based
measurement, such as O’Keefe (1985), Walter (1973),
Vissers and Wijingaard (1979), and Visser, (1979).

2.3.3. Fairness
Fairness represents the uniformity of performance of an
appointment system. It
evaluates the mean waiting time of patients according to
their place in the queue
(Bailey, 1952), variance of waiting time and queue size
(Blanco Whit and Pike, 1964, Fetter and Thompson, 1966,
Yang, Lau and Quek, 1998).

2.4. Overview of General Papers

Papers discussing the appointment issue focus on different
considerations using
different performance measurements. In general, the ways
to achieve that could be
divided into algorithm development and policy evaluation
by simulation tools.

2.4.1. Algorithm Development

Robinson and Chen (2003) and Mancilla and Storer (2012)
focus on algorithm
development. Robinson and Chen (2003) tried to balance
waiting time and idle time using Monte Carlo integration,
solve the problem approximately as a stochastic linear
program and develop an atheoretic closed-form heuristic
policy. Mancilla and Storer (2012) developed a stochastic
scheduling problem considering waiting and idle time and
overtime cost for operation room and surgery scheduling. A
multi-stage stochastic integer program using sample
average approximation was applied to solve this problem.
Erdogan, Denton and Gose (2011) also developed an
algorithm to solve dynamic
sequencing and scheduling of online appointments to a
single stochastic server. The objective was to minimize
patient waiting time (indirect and direct) and a clinic’s
overtime. In this study, it was assumed that service time
and the number of customers to be served are uncertain. A
special case of two customers was developed to provide
some insights to show tradeoff between the cost of waiting
time and likelihood of additional customers arriving. In this
special case, the online system scheduled one customer at
a time until the capacity limit was exceeded for a particular
day. A two sequencing decisions were assumed. One is
first-come- first-served (FCFS). The other one is add-on-
first-served (AOFS), in which the second (urgent add-on)
customer arrives after the first customer but schedule
before the first customer. Two-stage stochastic mixed
integer program was proposed to solve the problem. After
experimental analysis, they claimed that when all
customers have the same cost and service time
distribution, FSFC is better than AOFS. If indirect waiting
costs are high for add-on customers, they should be
scheduled first, otherwise they should be scheduled last.

2.4.2. Policy Evaluation by Simulation

Daggy et al. (2010) considered a problem that included no
show probabilities for each patient the objective is to
optimize the number of patients served, the utilization of
physicians, and minimizing physician overtime. The
patients’ no-show probabilities are estimated by applying a
multivariable logistic regression model for each patient.
Two policies are used to make a comparison. The one-slot
policy is to assign one patient to each time slot without
regard to no-show probability. The Mu-Law policy
considers different no-show probabilities and assigns a
weight to each type of patient. A simulation model was
built to compare these policies based on physician
utilization and overtime, number of patients served and
patient’s waiting time. LaGanga and Lawrence (2007)
considered a problem with no shoes and proposed
appointment overbooking to increase physician
productivity and overall clinic performance provide a
function a no-show rate and clinic size. Based on
simulation results, it turned out overbooking provides more
utility when no-show rates are high.
Cayirli et al. (2006) studied the sequence of schedule for
the new and returning
patients in an ambulatory care system. They considered
patient’s waiting time, physician’s idle time and overtime. A
simulation model was built in this study to test different
sequencing rules and scheduling rules. It was found that
sequencing rules have more impact on scheduling rules.

2.5. Review of Related Papers

The objective of this thesis is to maximize the number of
patients seen each day and number of patients assigned to
their top preferences. Scheduling of urgent patients is also
the consideration in this thesis. Some related papers are
reviewed as follows.
Wang and Gupta (2011) considered patients’ preferences
and acceptable combinations of physicians and time
blocks. They estimated patients’ preferences in terms of
acceptance probabilities, which contained difference
combinations of date, time and physicians. Second, they
assumed an online appointment scheduling system is
applied in which patients selected the one preferred date,
time blocks and physicians. After receiving the request, the
clinic scheduled one combination of date, time and
physicians. This decision was made based on 1) patients’
acceptability and arrival rates at the panel level, 2) average
revenue of each appointment, 3) average cost of delaying an
advance-book and same day appointment, 4) same-day
demand distribution for each physician. If clinic responded
that none of the combinations are available, patients can
repeat the booking process until they were assigned to an
available combination. Two approaches (policies) were
presented associated with decision-making. One (H1) is
patients are assigned to selected open slots. If more than
one time slots are available, the slots with smallest value of
appointment slots rank order. Another (H2) is similar with
the previous one expect it tries to protect slots for same-
day demand by avoiding assigning patients to slots
reserved for same-day demand. Compared with the straw
policy, they concluded that H1 and H2 can earn more
revenue when no-show probability is low.
Feldman et al. (2012) considered an electronic appointment
booking systems with patients’ preferences and no-show
probability. The objective of this paper was to maximize the
expected net “profit” for each day. The profit was the
difference between the cost of number of patients that
schedule an appointment and show up.
They assumed a single physician in the clinic. It was also
assumed that one patient can make an appointment on an
available day or leave without any appointment if the
preferences cannot be met. To estimate the no-show
probability, it was assumed that patient choice behavior
was followed by multinomial logit choice model. They
developed static and dynamic appointment scheduling
optimization models to solve the problem. The static model
did not consider the state of the booked appointments and
the result pointed out this model is suitable when patient
load is high. For dynamic model, it considered the state of
booked appointments. An approximate method was
proposed by applying a Markov decision process
formulation. A simulation study was conducted to compare
the four policies. The first and second policy were based on
the static and dynamic models respectively. The third
policy was a capacity controlled implementation of open
access. The last policy was a complement of the third policy
offering all days in the scheduling horizon. The criteria
were based on expected profit per day and percentage gap
between the expected profit per day for the second and
other policies. The result pointed out the second policy-
dynamic model was a better policy among all policies.
Vermealen et al. (2009) studied an online appointment
system considering different urgency of patients and their
preferences. This paper considered the situation when a
patient made an appointment for a diagnosis test. The
objective was to assign patients before their next consult
date with the physician. Non-urgent patients were assigned
based on minimum access time and urgent patients were
assigned to any timeslots left over on days before minimum
access time. When considering patients’ preference, three
boolean-type preference models were considered work/non-
work hours on one day, multiple preferred days and a
combination of previous two. Three benchmark policies
were proposed to make a selection based on a weighed
combination of scheduling performance (capacity
utilization) and patients’ preference fulfillment. The first
was to assign patients strictly to capacity of urgent/non-
urgent patients. The second was to assign patients to
capacity of equal or lower urgency. The last was to assign
patients to capacity of equal or lower urgency with dynamic
overflow. An experiment was conducted to compare the
three policies above. The result showed the trade-off
between schedule performance and patients’ preferences.
CHAPTER THREE – RESEARCH METHODOLOGY

3.1 METHODOLOGY

This chapter concerns with the introduction, research

methodology, analysis of current and existing system,

requirement specifications, analysis model, system

architecture, design model, and case tools/ UML modeling

tools.
This part will explain the different method that was used in

carrying out the research. The procedures and strategies

employed in the study were: Research design, area of the

study, population of the study and instrumentation.

3.1.1 Research design: the research was centered only on

Federal Medical Center (FMC). Data were collected from the

companies by the researcher in other to design the system.

3.1.1 Research Area: the area of the study is located in

Abuja. Abuja is the capital city of Nigeria. It is located in
the centre of Nigeria, within the Federal Capital
Territory (FCT). Abuja is a planned city[2], and was built
mainly in the 1980s. It officially became Nigeria's capital on
12 December 1991, replacing Lagos. At the 2006 census,
the city of Abuja had a population of 776,298. The
commercial activities that are found in Abuja are: Fishing,
farming, education, Industries, companies, etc.

3.1.2 Population of the Study:

Using University of Technology Hospital as case study, the

research is centered only in the Hospital. The Hosptial
comprises of staff, Patients, facilities, and stores.

3.3 Requirement Analysis Modelling

In the existing System it is difficult to maintain the

information of disaster and victim patients. Patient has to

face difficulty in getting close or to contact the hospital.

Our main idea is to develop a system where the patient can

make appointment with the doctors or the admin and also

for the patient to contact them immediately whenever there

is emergency. In the Proposed System, application can

maintain all details like Appointment Management, Contact

information, Reports and model etc. We can also view all

the report and list which are kept for sale effectively and we

can search for other agencies which will assist the hospital.

This application mainly consists of 4 modules: New

appointment module, View appointment module, Facebook

link module, and Twitter link module

New Appointment Module: This module is designed in such

a way that the doctor can have an appointment with the

patient by taking the patient name and scheduling time

and date for the patient to meet one on one.

View Appointment Module: In the view appointment

module, the doctor can view the list of appointment and

their date with the patient.

Facebook and twitter link Module: this module links to the

facebook site to see what the application is all about and

also the same in twitter.

Conclusions: The project can be expanded into a domain

for reviews and comparing models

3.4.1 Functional requirement

Requirement analysis is a software engineering technique

that is composed of the various tasks that determine

the needs or conditions that are to be met for a

new or altered  product, taking into consideration the

possible conflicting requirements of the various users.

Functional requirements are those requirements that

are used to illustrate the internal working nature of

the system, the description of the system, and

explanation of each subsystem. It consists of what

task the system should perform, the processes

involved, which data should the system holds and

the interfaces with the user. The functional

requirements identified are:

a. Appointment registration : The system

should allow new users to create an

appointment with the customer.

3.4.2 Non- Functional Requirements

It describes aspects of the system that are concerned

with how the system provides the functional
requirements. They are:

a. Performance and Response time:

The system should have high performance rate
when executing user’s input and should be able to
provide feedback or response within a short time
span usually 50 seconds for highly complicated task and
20 to 25seconds for less complicated task.
c. Error handling: 
Error should be considerably minimized and an
appropriate error message that guides the user to recover
from an error should be provided. Validation of user’s
input is highly essential. Also the standard time taken
to recover from an error should be 15 to 20 seconds.

d. Availability:
This system should always be available for access at 24
hours, 7 days a week. Also in the occurrence of any major
system malfunctioning, the system should be available in 1
to 2 working days, so that the business process is not
severely affected.
 
e. Ease of use:
Considered the level of knowledge possessed by the users
of this system, a simple but quality user interface should
be developed to make it easy to understand and required
less training.

3.5 Analysis Model

The system is made up of modules which are: Appointment

module, and the View appointment module.

3.5.1 Use case diagram

Appointment system
New View and read Contact the Hospital
Appointment appointment

3.5.2 Activity Diagram

Activity diagrams graphically represent the

s e q u e n t i a l b u s i n e s s a n d o p e r a t i o n a l workflows of

a system. It is a dynamic diagram that shows the activity

and the event that causes the object to be in the particular

state. The workflows from activity diagram will serve as

guide for system navigation in the final design phase of the

system.

3.5.2.1 Appointment System

Start
 In a list view
Appointme format: S/N,
nt Main Something, Date,
form Nothing

Date, Title, Time,

Description
View
New Appointment appointment

Submit
Stop

Record
saved

Stop

3.6 System Architecture

3.6.1 Physical architecture: Three/ Four Tier Language

Architecture

3.6.1.1 SYSTEM FLOWCHART

 Appointment
Management
System

3.6.1.2.1 SYSTEM REQUIREMENTS

Input From the
Keyboard

3.6.1.2 Logical architecture:

Result to Screen
Processor
Output (Report)
Disk
Storage
The requirements needed to implement this system are as
follows:
3.6.1.2.2 Hardware Requirements
The software designed needed the following hardware
for an effective operation of the newly designed system.
1. A system running on AMD, Pentium 2 or higher
processor
2. The random access memory (ram) should be at least
512mb.
3. Enhanced keyboard.
4. At least 20 GB hard disk.
5. V.G.A or a colored monitor.

3.6.1.2.3 Software Requirements

The software requirements includes:-
 A window 7 or higher version for faster processing.
 Xampp Server.
 Browser.
 Code Editor (notpad++)

3.7 Design Model

3.7.1 Class Design

 The class diagram is the main building block, a

number of classes are identified and grouped together

in a class diagram which helps to determine the

statically relations between those objects.

Main Form

New Appointment Menu

About
Date
An XAML file using visual
Title
studio and MS SQL
server. Time

Description

View appointment menu

S/N

Date

Something

Nothing

N/b: it must be in
listview
 CHAPTER FOUR

4.1 Introduction

This chapter is concern with the justification of the

software: the tools used in developing the software,

hardware and system requirement, instruction for software

development and installation, system testing and output

and then the documentation of the application.

4.2 Justification of Software Development

Tool/Environment

4.2.1 OUTPUT SPECIFICATION AND DESIGN

The output design was based on the inputs. The
report generated gives a meaningful report to the
management. These outputs can be generated as softcopy
or printed in hard copy.
4.2.2 INPUT DESIGN AND SPECIFICATION
Computer is designed in such a way that sometimes
it is called GIGO, denoting that what goes in is what
comes out. The input forms are designs generally based
on the necessary data that needs to be entered into the
system. The data are captured through the keyboard and
stored on a magnetic disk in an access database.
The new system is composed mainly of one input and
output forms, they include:-
 a) New Appointment form
b) View Appointment List form

4.1 Hardware Requirements

The software designed needed the following hardware
for an effective operation of the newly designed system.
1. A system running on AMD, Pentium 2 or higher
processor
2. The random access memory (ram) should be at least
512mb.
3. Enhanced keyboard.
4. At least 20 GB hard disk.
5. V.G.A or a colored monitor.

4.2 Software Requirements

The software requirements includes:-
 A window 7 or higher version for faster processing.
 Xampp Server.
 Code Editor (Notepad++).

4.3 DATA SOURCE

During the process of data collection, information relating

to Appointment Management System was obtained from

the Internet (www.wikipedia.com/appointment). The

 information was collected during the course of my

industrial attachment. Hence, it is assumed that all the

data collected are correct and contains no false

information.

4.4 Instructions for Software Development/Installation

1. Design an input format that will enable the users to

create new appointment.
2. Design an Output format that will enable the user to
view appointment list.
3. Design a Main form with a logo in the middle.
4. Structure a database system that will store
all the information using Microsoft SQL
Server Express.
5. The programming language you will use html
and css, javascript and PHP Studio.net.
6. Employ a menu design on the main form.

4.5 System Testing and Output

The system was developed based on the accordance of the

instruction. It was tested for about 2 month to ensure it is

error free. Then it was sent to the supervisor for testing,

verifying and approval.

4.6 Documentation

The research work entitled “Design and implementation of

Appointment Management system” was done by me. It is a

case study of UNITEH hospital. The application was

developed with web app language serving as the

programming environment and Xampp server and MySQl

database.

Data were gathered using both the primary and the

secondary source. It took three to six weeks of findings and

four weeks in developing the application. Implementation of

the application of the application was successful. It was

verify by the supervisor before proceeding to the defense

hall.
The objective of the application was:

1. To allow the user to fix appointment with the patient.

2. Allows the user to view list of current appointment.
CHAPTER FIVE

5.1 SUMMARY
In summary, this Academic Work has done a great
deal of giving a broad knowledge of what Appointment
Management system is all about using University of
Technology Hospital as a case study. It went as far as
highlighting the works of the application.

5.2 CONCLUSION
From this Academic Work, I have been able to introduce
what the application is all about and how it can be used, it
has achieve the full aim of letting the public know what
Federal Medical Center (FMC) as a case study is all about.
Recommendation
I hereby recommend this Academic work to be used by staff
and management of ……. and indeed any other Institution
with similar structure and organizational framework for the
following reasons:
1. The academic work has been able to solve the problem
related to easy access of the organization Federal
Medical Center (FMC).
2. The application has allow the customer to have contact

with the agency whenever there is emergency

5.3 LIMITATION OF THE STUDY

• Unavailability of academic materials.
 • Transport problem

• Lack of financial support

• Lack of Time

• Unavailability of programming software such as php

and SQL.

REFERENCES

1. NEMA in Charlton T. Lewis and Charles Short (1879) A

Latin Dictionary, Oxford: Clarendon Press.

2. Burkingham, H. (1998). Information system analysis.

California: Olive Publishers

3. George Wills (2003). Management Information System.

London: Webster Publisher

4. Gronroos, C. (1990). Service management And

Marketing,

5. Laudon .J.P and Laudon K.C. (1991). Functions Of

Information System. London: Webster Publisher.

6. Lucy, t. (2001). Management Information Systems. 1st

ed., London: Dp Publishers,

7. Microsoft Corporation (2004). Programmer’s Guide,

Microsoft

8. Mihir, B. andPhillip, R. (2005).Introduction To Modern

Management Information System. California USA:

California Printing Press

9. Vossen, G. (1999). Data Models, Database Languages

and Database Management Systems. New York city:

Adison-Wesley

10. Federal Capital Territory (Nigeria)". City Population.

Retrieved 26 October 2015.

11. Jaiyeola, Andrews. "FCT Minister Harps on

Development of Satellite Towns".

12. Demographia (January 2015). Demographia World

Urban Areas (PDF) (11th ed.). Retrieved 2 March 2015.

13. "Federal Capital Territory (Nigeria)". City

Population. Retrieved 26 October 2015.

14. "Define Abuja's at Dictionary.com". Dictionary.com.

Random House, Inc. Retrieved 14 April 2015.

15. "Life of poverty in Abuja's wealth". news.bbc.co.uk.

BBC News, Tuesday, 13 February 2007. 2007-02-13.

Retrieved 2007-08-10.

16. "Legal Notice on Publication of 2006 Census Final

Results" (PDF). Policy and Legal Advocacy Centre.

Retrieved 10 June 2012.

17. "World's Fastest Growing Cities are in Asia and

Africa". Euromonitor. 2 March 2010. Archived from the

original on October 2015. Retrieved 26 October 2015.

18. "Top 5 Cities To Do Business In Nigeria. ABUJA Is

2nd". Abuja Facts. 22 April 2015. Retrieved 26 October

2015.

19. Jaiyeola, Andrews. "FCT Minister Harps on

Development of Satellite Towns".

20. Murray, Senan. "Life of poverty in Abuja's wealth."

BBC. Tuesday 13 February 2007. Retrieved on 12

September 2011.

21. https://www.naij.com/574434-nigeriaat55-top-5-

reasons-nigerias-capital-moved-lagos-abuja-

photos.html

22. Elleh, Nnamdi. Abuja, the single most ambitious

urban design project of the 20th century.

23. "World Bank Conference: African Regional

Roundtable on Upgrading Low-income Settlements"

(PDF). www.citiesalliance.org. World Bank, 3–5 October

2000, Johannesburg, South Africa, p. 16. Archived

 (PDF) from the original on 28 September 2007.

Retrieved 2007-08-10.

24. "Resettlement Issues, Squatter Settlements and the

Problems of Land Administration in Abuja, Nigeria's

Federal

25. Bailey, N. (1952). A study of queues and

appointment systems in hospital
26. out-patient departments, with special reference to
waiting-times. Journal of the
27. Royal Statistical Society. Series B
(Methodological) , 14 (2), 185-199.
28. 2. Banks, J. (1991). Selecting Simulation
Software. Proceding of the Winter
29. Simulation Conference.
30. 3. Blanco White, M., & Pike, M. (1964).
Appointment systems in outpatients' clinics
31. and the effect of patients' unpunctuality. Medical
Care , 2, 133-145.
32. 4. Bowser, D.; Utz, S.; Glick, D.; Harmon, R.
(2010). A systemetic review of the
33. realtionship of diabetes mellitus, depression, and
missed appointments in a
34. low-income uninsured population. Archives of
Psychiatric Nursing , 24 (5),
35. 317-329.
36. 5. Cayirli, T., & Veral, E. (2003). Outpatient
scheduling in health care: A review of
37. literature. Production and Operations Management
, 12 (4), 519-549.
38. 6. Cayirli, T., Veral, E., & Rosen, H. (2008).
Assessment of patient classification in
39. appointment system design. Production and
Operation Managemet , 9, 47-58.
40. 7. Cayirli, T., Veral, E., & Rosen, H. (2006).
Designing appointment scheduling
41. systems for ambulatory care services. Health Care
Managment Science , 9, 47–5.
42. 8. Changkong, V., & Haimes, Y. Y. (1983).
Multiobjective decision making theory
43. and methodolgy. New York: North-Holland.
44. 9. Chao, X., Liu, L., & Zheng, S. (2003). Resource
allocation in multisite service
45. 69
46. systems with intersite customer flows.
Management Science , 49 (12),
47. 1739–1752.
48. 10. Creemers, S., & Lambrecht, M. (2009). An
advanced queueing model to analyze
49. appointment-driven service systems. Computer
and Operations Research , 36
50. (10), 2773-2785.
51. 11. Daggy, J., Lawley, M., Willis, D., Thayer, D.,
Suelzer, C., DeLaurentis, P.-C.,
52. Turkcan, A., Chakraborty, S., & Sands, L. (2010).
Using no-show modeling to
53. improve clinic performance. Health Informatics
Journal , 16 (4), 246-259.
54. 12. Dove, H. G., & Schneider, K. (1981). The
usefulness of patients’ individual
55. characteristics in predicting no-shows in
outpatient clinics. Medical Care , 19 (7),
56. 734-740.
57. 13. Erdogan, A., Denton, B.T., &Gose, A. (2013).
Optimal online appointment
58. scheduling. Working Paper, Retrieved November
22, 2012, from
59. http://sitemaker.umich.edu/btdenton/files/Erdo
gan-2011b.pdf
60. 14. Feldman,J., Liu,N., Topaloglu, H., & Ziya,S.
(2012). Appointment scheduling
61. under patietn preference and no-show behavior.
Retrieved Septemenber 10, 2012,
62. from
63. http://www.columbia.edu/~nl2320/doc/patient_
scheduling_under_choice.pdf
64. 15. FETTER, R. A. (1966). Patients’ waiting time
and doctors’ idle tiime in the
65. outpatient setting. Health Services Research , 1
(1), 66–90.
66. 16. Gallucci, G., Swartz, W., & Hackerman, F.
(2005). Brief reports: Impact of the
67. wait for an initial appointment on the rate of kept
appointments at a mental health
68. 70
69. center, 56(3), Psychiatric Services , 344–346.
70. 17. Gross, D., & Harris, M. (1985). Fundamentals
of Queuing Theory, . New York,
71. USA: Wiley.
72. 18. Gupta, D., & Denton, B. (2008). Appointment
scheduling in health care:
73. Challenes and opportunites. IIE transaction , 40,
800-819.
74. 19. Hans, A. E. (1988). Multicriteria optimization
for highly accurate systems.
75. Multicriteria Optimization in Engineering and
Sciences , 19, 309-352.
76. 20. Ho, C., & Lau, H. (1999). Evaluating the
impact of operating conditions on the
77. performance of appointment scheduling rules in
service systems. European
78. Journal of Operational Research , 112 (3), 542–
553.
79. 21. Ho, C., & Lau, H. (1992). Minimizing total cost
in shceudling outpatient
80. appointments. Management Science , 38 (12),
1750-1764.
81. 22. Kaandorp, G., & Koole, G. (2007). Optimal
outpatient appointment scheduling.
82. Health Care Management Science , 10, 217-229.
83. 23. Klassen, K., & Rohleder, T. (1996). Scheduling
outpatient appointments in a
84. dynamic environment. Journal of Operations
Management , 14 (2), 83–101.
85. 24. LaGanga, L. R., & Lawrence, S. R. (2007).
Clinic overbooking to improve
86. patient access and increase provider productivity.
Decision Sciences , 38 (2),
87. 251-276.
88. 25. Lau, H., & Lau, A. H. (2000). A fast procedure
for computing the total system
89. cost of an appointment schedule for medical and
kindred facilities. IIE
90. Transactions , 32 (9), 833–839.
91. 71
92. 26. Law, A. M. (2007). Simulation Modeling and
Analysis. Boston: Suzanne Jeans.
93. 27. Lee, V., Earnest, A., Chen, M., & Krishnan, B.
(2005). Predictors of failed
94. attendances in a multi-specialty outpatient centre
using electronic databases.
95. BMC Health Services Research , 51–58.
96. 28. Mancilla, C & Storer R. H. (2012) Stochastic
integer programming based
97. algorithms for adaptable open block surgery
scheduling. Retrieved September 20,
98. 2012, from
http://www.lehigh.edu/inime/documents/12t_007.pd
f
99. 29. Neal, R., Hussain-Gambles, M., Allgar, V.,
Lawlor, D., & Dempsey, O. (2005).
100. Reasons for and consequences of missed
appointments in general practice in the
101. UK: Questionnaire survey and prospective review
of Medi- Cal Records. BMC
102. Family Practice , 6, 47.
103. 30. O’Hare, C., & Corlett, J. (2004). The outcomes
of open-access scheduling.
104. Family Practice Management , 11 (2), 35–38.
105. 31. O’Keefe, R. (1985). Investigating outpatient
departments: Implementable policies
106. and qualitative approaches. Journal of the
Operational Research Society , 36 (8),
107. 705–712.
108. 32. Robinson, L. W., & Chen, R. R. (2009). A
comparison of traditional and
109. open-access policies for appointment scheduling.
Manufactruing and Service
110. Operations Management , 12 (2), 1-17.
111. 33. Robinson, L. W., & Chen, R. R. (2003).
Scheduling doctors’ appointments:
112. Optimal and empirically-based heuristic policies.
IIE Transactions 35, . , 35 (3),
113. 295–307.
114. 72
115. 34. Schectman, J., Schorling, J., & Voss, J.
(2008). Appointment adherence
116. anddisparities in outcomes among patients with
diabetes. Journal of General
117. Internal Medicine , 23 (10), 1685-1687.
118. 35. Trust, N. P. (1955). Studies in the function
and design of hospitals. (p. 35).
119. London: Oxford Universierty Press.
120. 36. Vanden Bosch, P. M., Dietz, C. D., & Simeoni,
J. R. (1999). Scheduling customer
121. arrivals to a stochastic service system. Naval
Research Logistics , 46, 549–559.
122. 37. Vermeulen, I. B., Bohte, S. M., Bosman, P. A.,
Elkhuizen, S. G., Bakker, P. J., &
123. La Poutré, J. A. (2009). Optimization of online
patient scheduling with urgencies
124. and preferences. In C. Combi, A. Abu-hanna, & Y.
Shahar, Artificial Intelligence
125. in Medicine Lecture 5651 Notes in Computer
Science (pp. 71-80).
126. 38. Vissers, J. (1979). Selecting a suitable
appointment systems in an outpatient
127. setting. Medical Care , 17 (20), 1207-1220.
128. 39. Vissers, J., & Wijngaard, J. (1979). The
outpatient ap- pointment system: design
129. of a simulation study. Euro- pean Journal of
Operational Research 3: . 3, 459-463.
130. 40. Walter, S. D. (1973). A comparison of
appointment schedules in a Hospital
131. Radiology Department. British Journal of
Preventive and Social Medicine ,
132. 160-167.
133. 41. Wang, W., & Gupta, D. (2011). Adaptive
appointment systems with patient
 134. preferences. Manufacturing & Service Operations
Management , 13 (3),
135. 373–389.
136. 42. Wijewickrama, A., & Takakuwa, S. (2008).
Outpatient Appointment scheduling
137. 73
138. in a multi facility system. Winter Simulation
Conference , (pp. 1563-1571).
139. 43. Yang, K. K., Lau, M. L., & Quek, S. A. (1998).
A new appointment rule for a
140. single-server, multiple-customer service system.
Naval Research Logistics , 45,
141. 313–326.

APPENDICES

APPENDIX A – SCREEN SHOTS

Main Menu
New Appointment

APPENDIX B – SOURCE CODE

1. Main Window
2. ''' <summary>
3. ''' This file processes new appointments into the database
4. ''' Head to facebook.com/jdsitecare to leave any remarks and to keep up to date
with more progress and more releases.
5. ''' </summary>
6. ''' <remarks>Appointment Management is intended for programmers to play with it
and turn it into their own software if desired.
7. ''' This is a open source project and will remain open source.
8. ''' </remarks>
9. Class MainWindow
10. Public SetAppointment As New CreateAppointmentDataContext
11. Private Sub TitleBar_MouseDown(sender As Object, e As MouseButtonEventArgs)
Handles TitleBar.MouseDown
12. Me.DragMove()
13. End Sub
14.
15. Private Sub DayPick_SelectedDateChanged(sender As Object, e As
SelectionChangedEventArgs) Handles DayPick.SelectedDateChanged
16.
17. DateLabel.Content = DayPick.SelectedDate
18. End Sub
19.
20. Private Sub Button_Click(sender As Object, e As RoutedEventArgs)
21. 'Attempts to insert the new appointment into the database
22. 'newAppintment method is located in the createAppointment.dbml file (Yes,
spelling error detected ;)'
23. Try
24. SetAppointment.newAppintment(txtTitle.Text, DateLabel.Content,
cbHour.SelectedItem & ":" & cbHour.SelectedItem & cbAmPm.SelectedItem,
txtDescription.Text)
25. MsgBox("Appointment added")
26. Catch ex As Exception
27. MsgBox(ex.Message)
28. End Try
29. End Sub
30.
31. Private Sub Label_MouseDown(sender As Object, e As MouseButtonEventArgs)
32. Me.Close()
33. End Sub
34.
35. Private Sub MainWindow_Loaded(sender As Object, e As RoutedEventArgs) Handles
Me.Loaded
36. 'Inserts the numbers into the combo boxes under Hour and Minute
37. Dim h As Integer = 0
38. Dim m As Integer = 0
39.
40. For h = 0 To 12
41. cbHour.Items.Add(h)
42. Next
43.
44. For m = 0 To 31
45. cbMin.Items.Add(m)
46. Next
47.
48. cbAmPm.Items.Add("AM")
49. cbAmPm.Items.Add("PM")
50. End Sub
51. End Class

3. Module
4. Imports System.Data.SqlClient
5.
6. Module Module1
7. Public cn As New SqlConnection("Data Source=.\sqlexpress;Initial
Catalog=;Integrated Security=True;Pooling=False")
8. Public cmd As New SqlCommand
9. Public da As New SqlDataAdapter
10. Public dr As SqlDataReader
11. Public str As String
12.
13. Public Sub connecttodatabase()
14. cn.Open()
15. cmd = New SqlCommand("IF NOT EXISTS ( SELECT [name] FROM sys.databases
WHERE name = 'appointments' ) CREATE DATABASE appointments ", cn)
16. cmd.ExecuteNonQuery()
17. cn.ChangeDatabase("appointments")
18. cmd = New SqlCommand("if not exists (select * from sysobjects where
name='newApp' and xtype='U') CREATE TABLE newApp([Id] NVARCHAR (MAX) NULL,
[Title] NVARCHAR (MAX) NULL,[Date] DateTime NULL,[Time] DateTime NULL,
[Description] NVARCHAR (MAX) NULL)", cn)
19. cmd.ExecuteNonQuery()
20.
21. cn = New SqlConnection("Data Source=.\sqlexpress;Initial
Catalog=appointments;Integrated Security=True;Pooling=False")
22.
23. End Sub
24.
25. End Module
26.
3. View Dates
4. Public Class ViewDates
5.
6. Private Sub NewAppBindingNavigatorSaveItem_Click(sender As Object, e As
EventArgs)
7. Me.Validate()
8. Me.NewAppBindingSource.EndEdit()
9. Me.TableAdapterManager.UpdateAll(Me.AppointmentsDataSet)
10.
11. End Sub
12.
13. Private Sub ViewDates_Load(sender As Object, e As EventArgs) Handles
MyBase.Load
14. 'TODO: This line of code loads data into the 'AppointmentsDataSet.newApp'
table. You can move, or remove it, as needed.
15. Me.NewAppTableAdapter.Fill(Me.AppointmentsDataSet.newApp)
16.
17. End Sub
18. End Class