A simulation-based decision support system to prevent and predict strain situations in emergency department systems

• A simulation-based decision support system (DSS).
• Prevent and predict strain situations in an emergency department.
• Strain indicators and corrective actions.
• Real case study and simulation experiments.

The management of patient flow, especially the flow resulting from health crises in emergency departments (ED), is one of the most important problems managed by ED managers. To handle this influx of patients, emergency departments require significant human and material resources, but these are limited. Under these conditions, the medical and paramedical staff are often confronted with strain situations. To deal with these situations, emergency departments have no choice but to adapt. The main purpose of this article is to develop a simulation-based decision support system (DSS) to prevent and predict strain situations in an ED in order to improve their management by the hospital system. A discrete-event simulation model was constructed in order to visualize the strain situations, examine the relationship between the strain situations and propose corrective actions. A simulation experiment is presented with the results, identifying several important aspects of the strain situations and corrective actions in ED systems. The results have proven the importance of anticipation and management of strain situations in emergency departments.