Adaptive Double-Booking Strategy for Outpatient Scheduling Using Multi-Objective Reinforcement Learning
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| Format: | Preprint |
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2026
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| _version_ | 1866908871690289152 |
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| author | Amalina, Ninda Nurseha An, Heungjo |
| author_facet | Amalina, Ninda Nurseha An, Heungjo |
| contents | Patient no-shows disrupt outpatient clinic operations, reduce productivity, and may delay necessary care. Clinics often adopt overbooking or double-booking to mitigate these effects. However, poorly calibrated policies can increase congestion and waiting times. Most existing methods rely on fixed heuristics and fail to adapt to real-time scheduling conditions or patient-specific no-show risk. To address these limitations, we propose an adaptive outpatient double-booking framework that integrates individualized no-show prediction with multi-objective reinforcement learning. The scheduling problem is formulated as a Markov decision process, and patient-level no-show probabilities estimated by a Multi-Head Attention Soft Random Forest model are incorporated in the reinforcement learning state. We develop a Multi-Policy Proximal Policy Optimization method equipped with a Multi-Policy Co-Evolution Mechanism. Under this mechanism, we propose a novel τ rule based on Kullback-Leibler divergence that enables selective knowledge transfer among behaviorally similar policies, improving convergence and expanding the diversity of trade-offs. In addition, SHapley Additive exPlanations is used to interpret both the predicted no-show risk and the agent's scheduling decisions. The proposed framework determines when to single-book, double-book, or reject appointment requests, providing a dynamic and data-driven alternative to conventional outpatient scheduling policies. |
| format | Preprint |
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arxiv_https___arxiv_org_abs_2603_07270 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | Adaptive Double-Booking Strategy for Outpatient Scheduling Using Multi-Objective Reinforcement Learning Amalina, Ninda Nurseha An, Heungjo Machine Learning Patient no-shows disrupt outpatient clinic operations, reduce productivity, and may delay necessary care. Clinics often adopt overbooking or double-booking to mitigate these effects. However, poorly calibrated policies can increase congestion and waiting times. Most existing methods rely on fixed heuristics and fail to adapt to real-time scheduling conditions or patient-specific no-show risk. To address these limitations, we propose an adaptive outpatient double-booking framework that integrates individualized no-show prediction with multi-objective reinforcement learning. The scheduling problem is formulated as a Markov decision process, and patient-level no-show probabilities estimated by a Multi-Head Attention Soft Random Forest model are incorporated in the reinforcement learning state. We develop a Multi-Policy Proximal Policy Optimization method equipped with a Multi-Policy Co-Evolution Mechanism. Under this mechanism, we propose a novel τ rule based on Kullback-Leibler divergence that enables selective knowledge transfer among behaviorally similar policies, improving convergence and expanding the diversity of trade-offs. In addition, SHapley Additive exPlanations is used to interpret both the predicted no-show risk and the agent's scheduling decisions. The proposed framework determines when to single-book, double-book, or reject appointment requests, providing a dynamic and data-driven alternative to conventional outpatient scheduling policies. |
| title | Adaptive Double-Booking Strategy for Outpatient Scheduling Using Multi-Objective Reinforcement Learning |
| topic | Machine Learning |
| url | https://arxiv.org/abs/2603.07270 |