Improving decision-making and management of hospital resources: An application of the PROMETHEE II method in an Emergency Department

Abstract An Emergency Department (ED) is considered the heart of a hospital and in many cities around the world, and especially in developing countries such as Brazil, it is very often the sole source of medical care. Making decisions about hospital resource management is not a trivial activity and incorrect decision-making can have serious consequences on the quality of health care services provided to the community. This paper describes the application of the PROMETHEE II method to support decision-making and resource management in an ED. Multiple Criteria Decision Analysis (MCDA) is especially useful in systems in which decision-making is complex and involves different considerations. PROMETHEE II was chosen for this study because its outranking approach is considered appropriate for the decision context of hospital services. This method was tested and validated with experimental data from a Brazilian public hospital. The ranking showed the best alternatives to be implemented to improve the throughput of patients in the “Blue Room”. Six months after implementing the best alternatives, the waiting time during periods of overcrowding had been reduced by around 70%. The PROMETHEE II method proved to be a rational tool to support the Decision Maker (DM) to choose the best alternative to solve bottlenecks related to overcrowding in an ED. Improving decision-making in hospital departments means taking actions to increase the throughput of patients and reducing the number of patients-in-process.

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