BPMN-Based Simulation Analysis of the COVID-19 Impact on Emergency Departments: A Case Study in Italy

The COVID-19 outbreak, which has been recognized as a pandemic in March 2020, has brought the need to timely face an extraordinary demand of health-related resources and medical assistance. The objective of this work is to analyze the structural and procedural changes that have been enacted in an emergency department (ED), according to guidelines provided by national authorities. Specifically, guidelines deal with how to manage the access of COVID-19 patients, ensure the isolation of suspected cases, execute a proper triage, and identify the appropriate treatment path for all patients. The paper describes a process modeling and simulation-based approach to analyze the treatment of patients accessing the ED of an Italian hospital. The approach makes use of the Business Process Model and Notation standard to specify ED treatment processes before and during the pandemic, so to evaluate different scenarios and effectively support process improvement activities by use of simulation-based what-if analysis.