Hospital based Emergency Departments (EDs) serve as the primary gateway to the acute healthcare system, are struggling to provide timely care to a steadily increasing number of unscheduled visits. It is a highly integrated service units that primarily handles the needs of the patients arriving without prior appointment, and with uncertain conditions. In this context, analysis and management of patient flows play a key role in developing policies and decision tools for overall performance improvement of the system. However, patient flows in EDs are considered to be very complex because of the different pathways patients may take and the inherent uncertainty and variability of healthcare processes. Due to the complexity and crucial role of an ED in the healthcare system, the ability to accurately represent, simulate and predict performance of ED is invaluable for decision makers to solve operations management problems. One way to realize this requirement is by modeling and simulation.
In this thesis, we build high fidelity simulation tools to identify system bottleneck, quantitatively predict the benefit and cost of a policy, and discovery knowledge for a better understanding of the complex ED system. The agentbased model and simulation technique provides a flexible way to study ED operations as it predicts the systemlevel behavior from micro-level interactions, so as to see the forest through the trees. In this way, policies such as staffing could be changed and the effect on parameters such as waiting times and throughput could be quantified.
Here, we use agent-based model and simulation techniques to model the interaction of ED components (i.e, patient, nurse, doctor, equipment etc.). We then applied high performance computing techniques to execute the model and analyze simulation results. In summary, armed with the ability to execute a compute-intensive model and analyze huge datasets, the overall goal of this study is to develop tools to better understand the complexity (explain), evaluate policy (predict) and improve efficiencies (optimize) of ED units.