Optimization of French Hospital Department Activities Using an Efficient Discrete Event Simulation Model

A mismatch between patient demand and emergency departments (EDs)’ capacity to deliver care often leads to poor patient flow and overcrowding, and therefore an increase in waiting. This paper presents a mid-term decision support system dealing with scheduling and allocation of resources in the ED of the Hospital Center of Troyes, France. An efficient performance evaluation tool based on discrete event simulation (DES) is developed. Through a what-if scenario strategy, 145 scenarios were simulated that allowed us to create a new benchmark that does not exist in the literature. To rank and select the best alternatives, the VIKOR multicriteria analysis method and the entropy method were used. With the objective of minimizing the waiting time and inpatient stay under an additional resource cost constraint, this work has helped to quantify and analyze the impacts related to the structural and organizational reorganization of the ED.