Understanding Emergency Care Delivery Through Computer Simulation Modeling

Abstract

In 2017, Academic Emergency Medicine convened a consensus conference entitled, "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes." This article, a product of the breakout session on "understanding complex interactions through systems modeling," explores the role that computer simulation modeling can and should play in research and development of emergency care delivery systems. This article discusses areas central to the use of computer simulation modeling in emergency care research. The four central approaches to computer simulation modeling are described (Monte Carlo simulation, system dynamics modeling, discrete-event simulation, and agent-based simulation), along with problems amenable to their use and relevant examples to emergency care. Also discussed is an introduction to available software modeling platforms and how to explore their use for research, along with a research agenda for computer simulation modeling. Through this article, our goal is to enhance adoption of computer simulation, a set of methods that hold great promise in addressing emergency care organization and design challenges. W ith over 130 million annual ED visits,1 a declining number of EDs to provide emergency care, 2 and lengthening wait times to see providers, 3 EDs are operating under increasingly arduous conditions. One underutilized approach to addressing problems in health care quality and value, particularly in emergency care, is through the use of computer simulation modeling. Computer simulation is a method to build dynamic models that quantitatively abstract a system, such as a facility (e.g., ED) or a process (e.g., physician-in-triage). Not unlike "highfidelity patient simulation" for training clinicians in clinical care through the use of mannequins, computer simulation provides a platform to inform decision making prior to implementation in the real world.

Simedis 2.0 : On the Road Toward a Comprehensive Mass Casualty Incident Medical Management Simulator

“…Computer simulation modeling has been successfully used in non-medical contexts to analyze complex interactions and is increasingly recognized as a valid technique to analyze and optimize emergency medical management (Laker et al 2017). Because of the complexity involved, modeling and simulation are often limited to certain subprocesses of the MCI medical management such as transportation or allocation of casualties to hospitals (Timbie et al 2013).…”

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

“…Interestingly, all papers are qualitative studies, with the majority being conference papers published at the Winter Simulation Conference. The main results of the reviewed papers include (a) the advantages of using hybrid models [ 100 , 101 , 102 ], (b) selecting an appropriate simulation technique for different healthcare problems [ 103 , 104 , 105 ], and (c) presenting a framework for integrating simulation methods [ 106 , 107 , 108 , 109 , 110 , 111 , 112 ].…”

Modeling and Optimizing Patients’ Flows Inside Emergency Department based on the Simulation Model: A Case Study in an Algerian Hospital

“…Few authors have focused on human errors in the 'ED', which affect the quality of health care and has an impact on the waiting times. In [19], the authors developed a simulation-optimization model by modeling human errors. They evaluate three types of errors (unsafe transportation, repeated venipuncture, and sampling errors).…”