Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods

This article presents a method by which performances at an emergency department (ED) in a large hospital in Iran could be improved, where the long waiting times and unbalanced utilization create problems for patients and ED staff. This method firstly simulates patient flow in the ED and finds bottle...

Full description

Bibliographic Details
Main Authors: Alireza Gharahighehi, Amir Saman Kheirkhah, Ali Bagheri, Ehsan Rashidi
Format: Article
Language:English
Published: SAGE Publishing 2016-08-01
Series:Digital Health
Online Access:https://doi.org/10.1177/2055207616664619
_version_ 1811289193037430784
author Alireza Gharahighehi
Amir Saman Kheirkhah
Ali Bagheri
Ehsan Rashidi
author_facet Alireza Gharahighehi
Amir Saman Kheirkhah
Ali Bagheri
Ehsan Rashidi
author_sort Alireza Gharahighehi
collection DOAJ
description This article presents a method by which performances at an emergency department (ED) in a large hospital in Iran could be improved, where the long waiting times and unbalanced utilization create problems for patients and ED staff. This method firstly simulates patient flow in the ED and finds bottlenecks that cause inefficiency in ED performance. In the simulation model, patient arrival is assumed to be non-homogenous and the operation of medical tests such as MRI, CT scan, pathology testing, laboratory testing, ultrasonography, and radiology are detailed and virtual queues of patients' specimens are considered separately from patient queues. Based on the simulation reports of the current situation and target criteria, what-if scenarios were used to design scenarios that could improve ED performance. This method used the data envelopment method (DEA) to determine efficient scenarios, analytic hierarchy process (AHP) to specify the weight of each criterion, the Delphi method to specify suitable utilization rates for various resources, and the extended Vlsekriterijumska Optimizacija I KOmpromisno Resenje (VIKOR) method to compare data on 95% confidence intervals from efficient scenarios and to rank scenarios by considering conflicting criteria. Implementing the first scenario in the ranking would reduce acute patients' overall waiting time by approximately 5%, and it doesn't require any additional investments.
first_indexed 2024-04-13T03:50:34Z
format Article
id doaj.art-cc4b923599a14aca9957a99aaa6be681
institution Directory Open Access Journal
issn 2055-2076
language English
last_indexed 2024-04-13T03:50:34Z
publishDate 2016-08-01
publisher SAGE Publishing
record_format Article
series Digital Health
spelling doaj.art-cc4b923599a14aca9957a99aaa6be6812022-12-22T03:03:50ZengSAGE PublishingDigital Health2055-20762016-08-01210.1177/2055207616664619Improving performances of the emergency department using discrete event simulation, DEA and the MADM methodsAlireza GharahighehiAmir Saman KheirkhahAli BagheriEhsan RashidiThis article presents a method by which performances at an emergency department (ED) in a large hospital in Iran could be improved, where the long waiting times and unbalanced utilization create problems for patients and ED staff. This method firstly simulates patient flow in the ED and finds bottlenecks that cause inefficiency in ED performance. In the simulation model, patient arrival is assumed to be non-homogenous and the operation of medical tests such as MRI, CT scan, pathology testing, laboratory testing, ultrasonography, and radiology are detailed and virtual queues of patients' specimens are considered separately from patient queues. Based on the simulation reports of the current situation and target criteria, what-if scenarios were used to design scenarios that could improve ED performance. This method used the data envelopment method (DEA) to determine efficient scenarios, analytic hierarchy process (AHP) to specify the weight of each criterion, the Delphi method to specify suitable utilization rates for various resources, and the extended Vlsekriterijumska Optimizacija I KOmpromisno Resenje (VIKOR) method to compare data on 95% confidence intervals from efficient scenarios and to rank scenarios by considering conflicting criteria. Implementing the first scenario in the ranking would reduce acute patients' overall waiting time by approximately 5%, and it doesn't require any additional investments.https://doi.org/10.1177/2055207616664619
spellingShingle Alireza Gharahighehi
Amir Saman Kheirkhah
Ali Bagheri
Ehsan Rashidi
Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods
Digital Health
title Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods
title_full Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods
title_fullStr Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods
title_full_unstemmed Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods
title_short Improving performances of the emergency department using discrete event simulation, DEA and the MADM methods
title_sort improving performances of the emergency department using discrete event simulation dea and the madm methods
url https://doi.org/10.1177/2055207616664619
work_keys_str_mv AT alirezagharahighehi improvingperformancesoftheemergencydepartmentusingdiscreteeventsimulationdeaandthemadmmethods
AT amirsamankheirkhah improvingperformancesoftheemergencydepartmentusingdiscreteeventsimulationdeaandthemadmmethods
AT alibagheri improvingperformancesoftheemergencydepartmentusingdiscreteeventsimulationdeaandthemadmmethods
AT ehsanrashidi improvingperformancesoftheemergencydepartmentusingdiscreteeventsimulationdeaandthemadmmethods