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Emergency department optimization by simulation: two actual applications
No full textThe Emergency Department of a hospital is devoted to provide first aid to outpatients who suffer from
an injury or an illness requiring urgent care. Emergency Department service is characterized by: a) high
variability of patient arrivals, depending on time (day, week, year intervals ) and on exceptional events
(epidemics, maxiemergencies) occurring, according to extreme randomness; b) different required assistance
type according to patient characteristics and to suffered injury or illness; c) hard requirements for quick
(sometimes immediate) response, also in case of congestion. An emergency department shall be correctly
designed and managed for what concerns: a) structures (major treatment, minor treatment rooms, waiting
rooms, short term admission rooms, beds); b) technological resources (specifical instruments); c) human
resources (doctors, nurses, engineers and related working rules, turns of duty, etc.) in order to supply a
high quality service at minimum cost. Once given the presence of randomness in patient arrival, in patient
management (due to priorities and possible preemption) and in services’ duration, an analytical model is
hard to build and anyway not suitable, as it is able to provide only mean behaviour results, while a simulation
model is able to describe system behaviour in detail, and to give results related both to mean and to extreme
conditions. A correct organization and resource dimensioning is very important both in the planning and in
the management phase and may be usefully supported by a simulation model to be applied by administrators
and operators. As an emergency department is a very complex framework, a model which simulates it requires
a large amount of time and an expert software programmer to be built and implemented. In this paper we
employ a generalized flexible model built up by us and presented in a previous paper, able to reproduce
all common structural and functional characteristics of every actual emergency room only by adjusting
functional parameters. This simulation model was adapted to two actual emergency departments requiring
reorganization as they evidenced performance problems. By an easy simulation exercise: a) present situations
were reproduced and weak organizational aspects of system behaviour analyzed; b) a new dimensioning of
employed resources and working rules were suggested and tested by means of parameters setting; c) new
dimensioning was evaluated in terms of economical and social costs
Simulation model for efficient and safe sectorization in an air traffic area control center
No full textThe air traffic control system gives guidance to prevent collisions and manage efficient traffic flow. Enroute air traffic controllers are persons in charge to expedite and maintain a safe and orderly aircraft flow over a given geographic area through the use of long-range radar. The day-to-day problems faced by the air traffic control system are primarily related to the volume of air traffic demand placed on the system, and weather. Controllers work in facilities called Area Control Centers (ACCs). The area controlled by each ACC is subdivided into vertical and horizontal sectors. Today technologies allow a flexible “sectorizations” of an ACC depending on the traffic demand. Controller workload is a function of the number of aircraft flying in the same sector and of safety constraints; this implies that there is an upper limit on the number of planes that can be simultaneously controlled. Different sectorization may affect this limit.
We propose an innovative and flexible simulation model (implemented on a PC by means of a low cost package) based on expected traffic data, that may help decision makers in determining the ACC sectorization in order to properly address traffic demand. Experiences on the Padova ACC in Italy are reported
Soluzione ottima di problemi di decisione sequenziale senza limite a priori sul numero di osservazioni
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