Analysis and optimization of the Emergency Department at Beth Israel Deaconess Medical Center via simulation

Abstract

We develop a simulation model based on patient data from 2/1/05 to 1/31/06 that represents the operations of the Emergency Department at Beth Israel Deaconess Medical Center, a Harvard teaching hospital and a leading medical institution. The model uses a multiclass representation of patients, a time-varying arrival process module that uses multivariate regression to predict future patient arrivals, and a service module that takes into account the fact that service times decrease and capacity increases when the system becomes congested. We show that the simulation model results in predictions of waiting times that closely match those observed in the data. Most importantly, we use the simulation model to propose and analyze new policies such as increasing the number of beds, reducing the downtime between patients, and introducing a point of care lab testing device. The model predicts that incorporating a suite of these proposed changes will result in 21% reduction in waiting times.