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On-line strategy selection for reducing overcrowding in an Emergency Department

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  • Fabbri, Cristiano
  • Lombardi, Michele
  • Malaguti, Enrico
  • Monaci, Michele

Abstract

Overcrowding is a well-known major issue affecting the behavior of an Emergency Department (ED), as it is responsible for patients’ dissatisfaction and has a negative impact on the quality of workers’ performance. Dealing with overcrowding in an ED is complicated by lack of its precise definition and by exogenous and stochastic nature of requests to be served. In this paper, we present a Decision Support System (DSS) based on the integration of a Deep Neural Network for dealing with the sources of uncertainty and a simulation tool to evaluate how specific management policies affect the ED behavior. The DSS is designed to be run on-line, dynamically suggesting the most suitable policy to be implemented in the ED. We evaluate the performance of the DSS on a specific major ED located in northern Italy. Numerical results show that overcrowding can be considerably reduced by allowing a dynamic selection among a limited set of simple policies for queue management.

Suggested Citation

  • Fabbri, Cristiano & Lombardi, Michele & Malaguti, Enrico & Monaci, Michele, 2024. "On-line strategy selection for reducing overcrowding in an Emergency Department," Omega, Elsevier, vol. 127(C).
  • Handle: RePEc:eee:jomega:v:127:y:2024:i:c:s0305048324000641
    DOI: 10.1016/j.omega.2024.103098
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    References listed on IDEAS

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    1. Azcarate, Cristina & Esparza, Laida & Mallor, Fermin, 2020. "The problem of the last bed: Contextualization and a new simulation framework for analyzing physician decisions," Omega, Elsevier, vol. 96(C).
    2. Duma, Davide & Aringhieri, Roberto, 2023. "Real-time resource allocation in the emergency department: A case study," Omega, Elsevier, vol. 117(C).
    3. J B Jun & S H Jacobson & J R Swisher, 1999. "Application of discrete-event simulation in health care clinics: A survey," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 50(2), pages 109-123, February.
    4. Grot, Matthias, 2024. "Decision support framework for tactical emergency medical service location planning," Omega, Elsevier, vol. 125(C).
    5. Julian Schiele & Thomas Koperna & Jens O. Brunner, 2021. "Predicting intensive care unit bed occupancy for integrated operating room scheduling via neural networks," Naval Research Logistics (NRL), John Wiley & Sons, vol. 68(1), pages 65-88, February.
    6. Zied Jemai & L. Aboueljinane & E. Sahin, 2013. "A review on simulation models applied to emergency medical service operations," Post-Print hal-01672393, HAL.
    7. Davide Duma & Roberto Aringhieri, 2020. "An ad hoc process mining approach to discover patient paths of an Emergency Department," Flexible Services and Manufacturing Journal, Springer, vol. 32(1), pages 6-34, March.
    8. Davies, R & Davies, HTO, 1994. "Modelling patient flows and resource provision in health systems," Omega, Elsevier, vol. 22(2), pages 123-131, March.
    9. Leo, Gianmaria & Lodi, Andrea & Tubertini, Paolo & Di Martino, Mirko, 2016. "Emergency Department Management in Lazio, Italy," Omega, Elsevier, vol. 58(C), pages 128-138.
    Full references (including those not matched with items on IDEAS)

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