ANALYSING THE ED PATIENT FLOW MANAGEMENT PROBLEM BY USING ACCUMULATING PRIORITY QUEUES AND SIMULATION-BASED OPTIMIZATION

This paper deals with the Emergency Department (ED) patient flow management problem. After triage, where acuity of patients illness is assessed, each patient waits for treatment. Different care requires disparate resources, leading to different care-paths in the ED. During treatment patients can be in a diversity of treatment stages (waiting for the first consultation, doing clinical tests, waiting for a second consultation, etc.). Therefore, the selection of the next patient to be seen by a physician is not trivial, especially when there are different quality goals to be attained simultaneously. This research investigates disciplines based on accumulation of priority while waiting (APQ). Pure priority disciplines are independent of the quality goals set for the ED while the new ones can be optimized to achieve those goals as much as possible. The optimal APQ policies are obtained by using simulation-based optimization. Both types of policies are tested in a real case.