Generating and evaluating simulation scenarios to improve emergency department operations

Overcrowding and long patient length of stay, staff shortage, arrival volume increases, and budget constraints are problems hampering ED operations (Sinreich and Marmor, 2005; Maull et al., 2009; NHS, 2010). This paper suggests a framework for schematic generation and evaluation of simulation scenarios to improve ED processes in real-life environments. We illustrate the application of our methodology in a specific ED. We contribute to the area of ED computer simulation by suggesting a methodology that offers the following advantages: (1) Simulation scenarios can be schematically formulated rather than based on trial-and-error experiments. (2) Scenario development can be integrated in the different stages of simulation model development to support designers and management in understanding ED problems, improvement goals, data that should be collected and operational changes that should be applied.