Resilience of a hospital Emergency Department under seismic event

The article presents a new simplified model for measuring the resilience of a hospital Emergency Department during a seismic event. The waiting time is used as performance parameter which is first evaluated using a discrete event simulation model of the Emergency Department. Then, a metamodel has been developed from the results of the discrete event simulation model for different emergency codes considering the amplitude of the seismic input and the number of resources available right after the seismic event. Results show that when an earthquake occurs, generating a seismic wave of injured patients going to the Emergency Department, the maximum waiting time is approximately 13 h when an emergency plan is not applied. Instead, if the emergency rooms are not functional, due to earthquake damages, the waiting time increases dramatically and the Emergency Department is no more able to provide a proper service to the incoming patients. The proposed Emergency Department model can be used not only to evaluate the performance of existing hospitals during an emergency, but also to design the proper size of a new Emergency Department in a region.

[1]  Michael Pidd,et al.  Tools for Thinking—Modelling in Management Science , 1997 .

[2]  L B Bourque,et al.  Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. , 1998, International journal of epidemiology.

[3]  Michel Bruneau,et al.  Physical infrastructure interdependency and regional resilience index after the 2011 Tohoku Earthquake in Japan , 2014 .

[4]  Soemon Takakuwa,et al.  Functional analysis for operating emergency department of a general hospital , 2004, Proceedings of the 2004 Winter Simulation Conference, 2004..

[5]  Yue Liu,et al.  A Bi-Level Model for Planning Signalized and Uninterrupted Flow Intersections in an Evacuation Network , 2012, Comput. Aided Civ. Infrastructure Eng..

[6]  Ruth Davies.  “See and Treat” or “See” and “Treat” in an emergency department , 2007, 2007 Winter Simulation Conference.

[7]  Chuck Zhang,et al.  Simulation and Analysis of Hospital Operations and Resource Utilization Using RFID Data , 2007, 2007 IEEE International Conference on RFID.

[8]  Michel Bruneau,et al.  Framework for analytical quantification of disaster resilience , 2010 .

[9]  Frank McGuire.  Using simulation to reduce length of stay in emergency departments , 1994, Proceedings of Winter Simulation Conference.

[10]  S B Boxerman.  Simulation modeling: a powerful tool for process improvement. , 1996, Best practices and benchmarking in healthcare : a practical journal for clinical and management application.

[11]  L. McMahon,et al.  Measuring Hospital Performance: The Development and Validation of Risk-Adjusted Indexes of Mortality, Readmissions, and Complications , 1990, Medical care.

[12]  Ashish Bhaskar,et al.  Fusing Loop Detector and Probe Vehicle Data to Estimate Travel Time Statistics on Signalized Urban Networks , 2011, Comput. Aided Civ. Infrastructure Eng..

[13]  Ivan Damnjanovic,et al.  Agent‐Based Modeling of Behavioral Housing Recovery Following Disasters , 2012, Comput. Aided Civ. Infrastructure Eng..

[14]  Robert B. van der Meer,et al.  Using OR to support the development of an integrated musculo-skeletal service , 2005, J. Oper. Res. Soc..

[15]  Xiaosi Zeng,et al.  Development of Recurrent Neural Network Considering Temporal‐Spatial Input Dynamics for Freeway Travel Time Modeling , 2013, Comput. Aided Civ. Infrastructure Eng..

[16]  L. McMahon,et al.  The Risk-Adjusted Mortality Index: A New Measure of Hospital Performance , 1988, Medical care.

[17]  S. Samaha,et al.  The use of simulation to reduce the length of stay in an emergency department , 2003, Proceedings of the 2003 Winter Simulation Conference, 2003..

[18]  S J Stratton,et al.  The 1994 Northridge Earthquake Disaster Response: The Local Emergency Medical Services Agency Experience , 1996, Prehospital and Disaster Medicine.

[19]  D L McArthur,et al.  Injury hospitalizations before and after the 1994 Northridge, California earthquake. , 2000, The American journal of emergency medicine.

[20]  Gian Paolo Cimellaro,et al.  Multidimensional Performance Limit State for Hazard Fragility Functions , 2011 .

[21]  E. Martin,et al.  Proposals to reduce over-crowding, lengthy stays and improve patient care: study of the geriatric department in Norway's largest hospital , 2003, Proceedings of the 2003 Winter Simulation Conference, 2003..

[22]  Alexander Komashie,et al.  Modeling emergency departments using discrete event simulation techniques , 2005, Proceedings of the Winter Simulation Conference, 2005..

[23]  Simaan M. AbouRizk,et al.  Modeling Framework and Architecture of Hybrid System Dynamics and Discrete Event Simulation for Construction , 2011, Comput. Aided Civ. Infrastructure Eng..

[24]  Gian Paolo Cimellaro,et al.  Quantification of Disaster Resilience of Health Care Facilities , 2009 .

[25]  Sarah W. Fraser,et al.  Using patient waiting-time data to improve the hospital bed-assignment process. , 2004, Joint Commission journal on quality and safety.

[26]  Michel Bruneau,et al.  Performance‐based metamodel for healthcare facilities , 2011 .

[27]  D. Davis,et al.  Hospital Bed Surge Capacity in the Event of a Mass-Casualty Incident , 2005, Prehospital and Disaster Medicine.