Modeling and simulation of patient flow at the emergency services : Case of Al-Zahraa Hospital University Medical Center in Lebanon

Recently, the emergency departments of hospitals are experiencing an exponential growth of their activities. As a consequence, we list the impact of their loads on the length of the waiting time (for patients) and on the optimal use of resources for the treatment of vital emergencies. This requires a reflection on the management of patient flow (or journey) in arriving to the emergency services. Given the heterogeneity of emergency levels and the diversity of expectations of patients, it is necessary to analyze the dynamics governing the flow of patients. In this perspective, we are interested in this paper in the modeling and simulation of the flow of patients in the emergency department (ED) at Al-Zahraa Hospital University Medical Center in Beirut (Lebanon). Our goal is, in fact, to identify the factors that have significant impact on the length of stay spent by the patients in the ED. In order to improve the quality of the patient supervision, our target is to minimize the total length of stay and waiting times, we use two scenarios for the resources scheduling in the ED: the first one was used before March 2018, and the second is the actual schedule. In our methodology, we build a simulation model based on the collected data, then the simulation model is validated by the head of Emergency Department and by the experts. Therefore, we propose many scenarios applied in simulations instances realized using Rockwell ARENA simulator to evaluate the impact of these proposals to give the ED supervisors many recommendations that improve the issues identified during the modeling phase.