A hybrid model to support decision making in emergency department management

Pegoraro, Fábio; Santos, Eduardo Alves Portela; Loures, Eduardo de Freitas Rocha; Laus, Fernanda Wanka

doi:10.1016/j.knosys.2020.106148

Cited by 28 publications

(18 citation statements)

References 45 publications

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“…PROMETHEE is a set of MCDAs proposed by Brans & Mareschal in 1982. The earliest research projects using them in a HC context were published in 2002, and they studied the prioritization of a given resource across hospital departments [39,40]. Public health organizations should be encouraged to to adapt, use and share PROMETHEE as an effective approach to enable the integration of multiple perspectives in the control of public healtht issues [26].…”

Section: Promethee IImentioning

confidence: 99%

Interoperability Assessment of Emergency Department Processes Based on Multicriteria Decision-Making Methods

Laus

Pegoraro

Loures

et al. 2022

Preprint

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It is noticeable that, because of the amount and quality of information exchanged and the criticality of the decisions guided by them, hospitals are considered as some of the most complex organizations in modern society. Evidencing it, emergency departments in hospitals are examples of such complex environments that need perfect integration among systems, people, departments, and data. The processes behind the Emergency Department (ED) routine cause a set of critical and time-dependent decision-making, which must consider several criteria related to organizational and clinical attributes. Based on the literature and worldwide initiatives related to managing complex organizations, an ED can be interpreted through the enterprise interoperability (EI) lens, a concept related to the capability of different systems to work collaboratively within and throughout the organization. Thus, this paper proposes a framework focusing on interoperability assessment in ED processes, where different actors need to interoperate. The proposed framework for Enterprise Interoperability Assessment (EIA) is based on multicriteria decision analysis (MCDA) methods, considering organizational and clinical attributes of the ED. The Analytic Hierarchy Process (AHP) and Preference Ranking Organization Method for Enrichment Evaluation II (PROMETHEE II), in an integrated approach, were elected as the most appropriate multicriteria methods to support, respectively, diagnostic (interoperability assessment) and decisional (interoperability improvements) processes in this background. Last, to validate the framework proposed, a case study was carried out at a stroke unit in a University Hospital (UH) in the south of Brazil. The outcome inferred that the UH achieved the intermediate level of enterprise interoperability in stroke treatment, and Business and Information Technology concerns were found to be the priorities, which deserved greater efforts, to enhance interoperability.

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Section: Promethee IImentioning

confidence: 99%

Interoperability Assessment of Emergency Department Processes Based on Multicriteria Decision-Making Methods

Laus

Pegoraro

Loures

et al. 2022

Preprint

Self Cite

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“…The simulated ABS and DES designs are based on the proposed operational patient flow to reflect the defined steps of the proposed operational patient flow, as described in Section III, B.1. The rate of patient arrival by walk-in is set to 0.14 per minute, and the rate of patient arrival by ambulance is set to 0.05 per minute, in line with prior studies [51]. A detailed explanation of the simulation model documentation is presented in Appendix A.…”

Section: ) Proposed Operational Patient Flowmentioning

confidence: 99%

SIM-PFED: A Simulation-Based Decision Making Model of Patient Flow for Improving Patient Throughput Time in Emergency Department

2021

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Healthcare sectors face multiple threats, and the hospital emergency department (ED) is one of the most crucial hospital areas. ED plays a key role in promoting hospitals' goals of enhancing service efficiency. ED is a complex system due to the stochastic behavior of patient arrivals, the unpredictability of the care required by patients, and the department's complex nature. Simulations are effective tools for analyzing and optimizing complex ED operations. Although existing ED simulation models have substantially improved ED performance in terms of ensuring patient satisfaction and effective treatment services, many deficiencies continue to exist in addressing the key challenge in ED, namely, long patient throughput time. The patient throughput time issue is affected by causative factors, such as waiting time, length of stay, and decision-making. This research aims to develop a new simulation model of patient flow for ED (SIM-PFED) to address the reported key challenge of the patient throughput time. SIM-PFED introduces a new process for patient flow in ED on the basis of the newly proposed operational patient flow by combining discrete event simulation and agent-based simulation and applying a multi-attribute decisionmaking method, namely, the technique for order preference by similarity to the ideal solution. Experiments were performed on three actual hospital ED datasets to assess the effectiveness of SIM-PFED. Experimental results revealed the superiority of SIM-PFED over other alternative models in reducing patient throughput time in ED by consuming less patient waiting time and having a shorter length of stay. The findings also demonstrated the effectiveness of SIM-PFED in helping ED decision-makers select the best scenarios to be implemented in ED for ensuring minimal throughput time while being cost effective.

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“…In the literature, many studies have addressed EDM problems within the framework of MCDM [ 7 , 26 , 45 , 55 , 62 , 70 ]. Previous works on solving EDM problems mainly concentrated on selecting the best emergency response alternative from several ones based on multiple criteria, and rarely considered the synergy among alternatives supplied by different emergency departments.…”

Section: Introductionmentioning

confidence: 99%

“…Different approaches have been adopted to rank the EDM solutions, such as Technique in Order of Preference by Similarity to Ideal Solution (TOPSIS) [ 2 ], VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) [ 60 ], Weighted Distance Based Approximation (WDBA) and COmbinative Distance-based ASsessment (CODAS) [ 46 ], DEcision-MAking Trial and Evaluation Laboratory (DEMATEL) [ 4 ], QUALItative FLEXible multiple criteria (QUALIFLEX) [ 11 ] and Preference Ranking Organization METHod for Enrichment Evaluations II (PROMETHEE II) [ 45 ]. Although these methods are beneficial to EDM, they assume that DMs are completely rational.…”

Section: Introductionmentioning

confidence: 99%

A collaborative emergency decision making approach based on BWM and TODIM under interval 2-tuple linguistic environment

Chai

Duan

et al. 2021

Int. J. Mach. Learn. & Cyber.

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Emergencies require various emergency departments to collaborate to achieve timely and effective emergency responses. Thus, the overall performance of emergency response is influenced not only by the efficiency of each department alternative but also by the coordination effect among different department alternatives. This paper proposes a collaborative emergency decision making (CEDM) approach considering the synergy among different department alternatives based on the best–worst method (BWM) and TODIM (an acronym in Portuguese of interactive and multiple attribute decision making) method within an interval 2-tuple linguistic environment. First, the evaluation information provided by decision makers (DMs) is represented by interval 2-tuple linguistic variables to reflect and model the underlying diversity and uncertainty. On the basis of the DMs’ evaluations, the individual and collaborative performance evaluations of multi-alternative combinations composed of different department alternatives are constructed. Then, the BWM is extended into interval 2-tuple linguistic environment to obtain the weights of evaluation criteria, where the group decision making is taken into account in an interval fuzzy mathematical programming model. Furthermore, to derive more practical and accurate decision results, an interval 2-tuple linguistic TODIM (ITL-TODIM) method is proposed by considering the DMs’ psychological behaviours. In the developed ITL-TODIM method, both the gain and loss degrees of one alternative relative to another are simultaneously computed. Finally, a numerical example is presented to illustrate the applicability of the proposed method. Sensitivity and comparative analyses are also provided to demonstrate the effectiveness and advantages of the proposed approach.

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A hybrid model to support decision making in emergency department management

Cited by 28 publications

References 45 publications

Interoperability Assessment of Emergency Department Processes Based on Multicriteria Decision-Making Methods

Interoperability Assessment of Emergency Department Processes Based on Multicriteria Decision-Making Methods

SIM-PFED: A Simulation-Based Decision Making Model of Patient Flow for Improving Patient Throughput Time in Emergency Department

A collaborative emergency decision making approach based on BWM and TODIM under interval 2-tuple linguistic environment

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