Background: The Midwestern University College of Veterinary Medicine hosts student-run clinics that offer free veterinary services to underserved populations. This study sought to determine predictors of clinic and appointment durations and the feasibility of a capacity-based scheduling system using factors identified prior to physical examination. Methods: Medical records, appointment duration, clinic duration, number of patients and number of owners were collected for 20 clinics over 21 months. Detailed patient signalment, history, and physical examination findings were coded for all clinics. Clinic duration was analyzed via linear regression.  Appointment duration was analyzed via multiple multilevel mixed-effects linear regression clustered on date. Results: There were 385 appointments, with 301 (78%) having complete start and end times. Median clinic duration was 8 hours (interquartile range [IQR] 2.7-3.5), with number of patients (B=5.4, p=0.001) being predictive, and estimated optimum number of patients being 16-17 in order to maximize patients seen while minimizing the chance of exceeding 2.5 hours for the clinic. Median appointment duration was 20 minutes (IQR 13-30), with the number of current concerns expressed by owner (B=1.8, p=0.005), number of abnormal findings on physical examination (B=1.9, p<0.001), number of procedures (B=3.0, p<0.001), number of tests (B=4.3, p=0.015) and appointment position (B=-0.8, p<0.001) being significant. Conclusions: No variable available at check-in was found to explain more than 3% of the variation in appointment duration, and no variable available after the comprehensive history-taking process was found to explain more than 14% of variation. Even models that incorporated multiple variables from all stages were only able to explain one-fourth to one-third of the observed variation for either appointment or clinic duration. It is unlikely that a rubric constructed from information available prior to physical examination would be more helpful than number of patients, which explained 61% of clinic duration, for capacity-based scheduling.

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Background: The Midwestern University College of Veterinary Medicine hosts student-run free clinics through the campus-wide interprofessional program, Health Outreach through Medicine and Education. Veterinary students, attending veterinarians, and non-medical volunteers conduct clinics on a first-come-first-served basis. Patients are declined once estimated capacity is reached. Historically, capacity was based on the number of patients, but clinic end-time was found to be highly variable. An appointment complexity categorization system based on presenting complaint (used as a proxy for appointment duration) was implemented in an attempt to maximize patients seen while allowing for an on-time clinic conclusion. Methods: A rubric was constructed based on prior clinical experience and provided to non-medical personnel assisting with check-in to determine a point value (1-3) for each patient, with lower point value appointments being simpler, and higher point appointments being more complex. Clinic capacity was set at 24 points. Appointment duration for each point category was analyzed via Kruskal-Wallis equality of populations rank test and Dunn's test of multiple comparisons. Results: Median duration was the same for 1- and 2-point appointments (24 minutes), but longer for 3-point appointments (62 minutes). Duration of 3-point appointments was significantly different than 1-point (p=0.0071) and 2-point (p=0.0201) appointments, while duration between 1- and 2-point appointments was not different. Conclusions: Non-medical personnel using a rubric were able to discriminate between simple (1-point) and complex (3-point) appointments but were unable to discriminate between simple and complicated (2-point) appointments. However, this utility of this in clinical practice was minimal.