Improving the operations of an emergency department (ED) using a combined approach of simulation and analytical hierarchical process (AHP)

ABSTRACT This paper presents the results concerning the evaluation of the processes of an Emergency Department (ED). Based on the analysis of both processes and data flow, a simulation model of patient throughput in the ED has been developed. Simulation results, obtained using the JaamSim software, pointed out the strengths and weaknesses of the departments’ operations. Then, several alternative scenarios (hypothetical solutions) were created and tested, while the results were thoroughly analysed. In order to prioritise the several scenarios, two hierarchical processes were used. Firstly, a multicriteria table was developed based on decision makers’ personal preference. Total length of stay was acknowledged as the factor with the higher importance. Consequently, the application of an analytical hierarchical process (AHP) managed to verify the primary ranking. A comparison of the proposed ideas was attempted, featuring the implementation of a fast track unit as the best practice.