Online Optimisation of Casualty Processing in Major Incident Response

Recent emergency response operations to Mass Casualty Incidents (MCIs) have been criticised for a lack of coordination, implying that there is clear potential for response operations to be improved and for corresponding benefits in terms of the health and well-being of those affected by such incidents. In this thesis, the use of mathematical modelling, and in particular optimisation, is considered as a means with which to help improve the coordination of MCI response. Upon reviewing the nature of decision making in MCIs and other disaster response operations in practice, this work demonstrates through an in-depth review of the available academic literature that an important problem has yet to be modelled and solved using an optimisation methodology. This thesis involves the development of such a model, identifying an appropriate task scheduling formulation of the decision problem and a number of objective functions corresponding to the goals of the MCI response decision makers. Efficient solution methodologies are developed to allow for solutions to the model, and therefore to the MCI response operation, to be found in a timely manner. Following on from the development of the optimisation model, the dynamic and uncertain nature of the MCI response environment is considered in detail. Highlighting the lack of relevant research considering this important aspect of the problem, the optimisation model is extended to allow for its use in real-time. In order to allow for the utility of the model to be thoroughly examined, a complementary simulation is developed and an interface allowing for its communication with the optimisation model specified. Extensive computational experiments are reported, demonstrating both the danger of developing and applying optimisation models under a set of unrealistic assumptions, and the potential for the model developed in this work to deliver improvements in MCI response operations

Online optimization of casualty processing in major incident response: An experimental analysis

When designing an optimization model for use in mass casualty incident (MCI) response, the dynamic and uncertain nature of the problem environment poses a significant challenge. Many key problem parameters, such as the number of casualties to be processed, will typically change as the response operation progresses. Other parameters, such as the time required to complete key response tasks, must be estimated and are therefore prone to errors. In this work we extend a multi-objective combinatorial optimization model for MCI response to improve performance in dynamic and uncertain environments. The model is developed to allow for use in real time, with continuous communication between the optimization model and problem environment. A simulation of this problem environment is described, allowing for a series of computational experiments evaluating how model utility is influenced by a range of key dynamic or uncertain problem and model characteristics. It is demonstrated that the move to an online system mitigates against poor communication speed, while errors in the estimation of task duration parameters are shown to significantly reduce model utility

Genetic Algorithm Approach for Casualty Processing Schedule

Searching for an optimal casualty processing schedule can be considered a key element in the MCI response phase. Genetic algorithm (GA) has been widely applied for solving this problem. In this paper, it is proposed a GA-based optimization model for addressing the casualty processing scheduling problem (CPSP). It aims to develop a GA-based optimization model in which only a part of the chromosome (solution) involves in the evolutionary process. This can result in a less complex training process than previous GA-based approaches. Moreover, the study attempts to investigate two common objectives in CPSP: maximizing the number of survivals and minimizing the makespan. The proposed GA-based model is evaluated on two real-world scenarios in the Republic of Moldova, FIRE, and FLOOD. The paper suggests that GA models with a population size of 500 or smaller can be applied for MCI scenarios. The first objective can help many casualties receiving specialization treatments at hospitals

Modeling uncertain and dynamic casualty health in optimization-based decision support for mass casualty incident response

When designing a decision support program for use in coordinating the response to Mass Casualty Incidents, the modelling of the health of casualties presents a significant challenge. In this paper we propose one such health model, capable of acknowledging both the uncertain and dynamic nature of casualty health. Incorporating this into a larger optimisation model capable of use in real-time and in an online manner, computational experiments examining the effect of errors in health assessment, regular updates of health and delays in communication are reported. Results demonstrate the often significant impact of these factors

Prioritized Criteria for Casualty Distribution following Trauma-related Mass Incidents; a Modified Delphi Study

Introduction: In the aftermath of mass casualty incidents (MCIs), many decisions need to be made in a fast and influential manner in a high pressure environment to distribute the limited resources among the numerous demands. This study was planned to rank the criteria influencing distribution of casualties following trauma-related MCI. Methods: This study utilized a modified Delphi methodology, concentrating on extracted criteria attained from preceding systematic literature reviews. The 114 extracted criteria were classified into eight sections including space, staff, equipment, system and structures, triage, treatment, transport, and uncategorized criteria and were imported into an online survey tool. In the first round, experts were asked to rank each criterion on a five-point Likert scale. The second round incorporated feedbacks from the first round, stating percent and median scores from the panel as a whole. Experts were then called upon to reassess their initial opinions regarding uncertain remarks from the first round, and once again prioritize the presented criteria. Results: Fifty-seven criteria were regarded as relevant to the following sections: space: 70% (7/10); staff: 44% (4/9); system / structure: 80% (4/5); equipment: 39.1% (9/23); treatment; 66.7% (6/9); triage: 73.7% (14/19); transport: 38.7% (12/31) and other sections: 12.5% (1/8). The first round achieved nearly 98% (n=48) response rate. Of the 114 criteria given to the experts, 68 (almost 60%) were approved. The highest percentage of approval belonged to the system and structures sections (4/5=80%). The response rate for the second round was about 86% (n=42). A consensus could be reached about nearly 84% (57) of the 68 criteria presented to experts. Conclusion: "Casualty Level of Triage on the Scene" and "Number of Available Ambulances" were the two criteria that obtained the highest level of consensus. On the other hand, "gender of casualty", "Number of Non-Medical staff in each Hospital" and "Desire to transport family members together" got lowest level of consensus. This sorted list could be used as a catalogue for developing a decision support system or tool for distribution of victims following mass casualty incidents. KEYWORDS:Mass casualty incidents; decision making; supply and distribution; wounds and injurie

Optimizing fire station locations for the Istanbul metropolitan municipality

Copyright @ 2013 INFORMSThe Istanbul Metropolitan Municipality (IMM) seeks to determine locations for additional fire stations to build in Istanbul; its objective is to make residences and historic sites reachable by emergency vehicles within five minutes of a fire station’s receipt of a service request. In this paper, we discuss our development of a mathematical model to aid IMM in determining these locations by using data retrieved from its fire incident records. We use a geographic information system to implement the model on Istanbul’s road network, and solve two location models—set-covering and maximal-covering—as what-if scenarios. We discuss 10 scenarios, including the situation that existed when we initiated the project and the scenario that IMM implemented. The scenario implemented increases the city’s fire station coverage from 58.6 percent to 85.9 percent, based on a five-minute response time, with an implementation plan that spans three years

AGENT-BASED DISCRETE EVENT SIMULATION MODELING AND EVOLUTIONARY REAL-TIME DECISION MAKING FOR LARGE-SCALE SYSTEMS

Computer simulations are routines programmed to imitate detailed system operations. They are utilized to evaluate system performance and/or predict future behaviors under certain settings. In complex cases where system operations cannot be formulated explicitly by analytical models, simulations become the dominant mode of analysis as they can model systems without relying on unrealistic or limiting assumptions and represent actual systems more faithfully. Two main streams exist in current simulation research and practice: discrete event simulation and agent-based simulation. This dissertation facilitates the marriage of the two. By integrating the agent-based modeling concepts into the discrete event simulation framework, we can take advantage of and eliminate the disadvantages of both methods.Although simulation can represent complex systems realistically, it is a descriptive tool without the capability of making decisions. However, it can be complemented by incorporating optimization routines. The most challenging problem is that large-scale simulation models normally take a considerable amount of computer time to execute so that the number of solution evaluations needed by most optimization algorithms is not feasible within a reasonable time frame. This research develops a highly efficient evolutionary simulation-based decision making procedure which can be applied in real-time management situations. It basically divides the entire process time horizon into a series of small time intervals and operates simulation optimization algorithms for those small intervals separately and iteratively. This method improves computational tractability by decomposing long simulation runs; it also enhances system dynamics by incorporating changing information/data as the event unfolds. With respect to simulation optimization, this procedure solves efficient analytical models which can approximate the simulation and guide the search procedure to approach near optimality quickly.The methods of agent-based discrete event simulation modeling and evolutionary simulation-based decision making developed in this dissertation are implemented to solve a set of disaster response planning problems. This research also investigates a unique approach to validating low-probability, high-impact simulation systems based on a concrete example problem. The experimental results demonstrate the feasibility and effectiveness of our model compared to other existing systems

Optimizing fire station locations for the Istanbul metropolitan municipality

Copyright @ 2013 INFORMSThe Istanbul Metropolitan Municipality (IMM) seeks to determine locations for additional fire stations to build in Istanbul; its objective is to make residences and historic sites reachable by emergency vehicles within five minutes of a fire station’s receipt of a service request. In this paper, we discuss our development of a mathematical model to aid IMM in determining these locations by using data retrieved from its fire incident records. We use a geographic information system to implement the model on Istanbul’s road network, and solve two location models—set-covering and maximal-covering—as what-if scenarios. We discuss 10 scenarios, including the situation that existed when we initiated the project and the scenario that IMM implemented. The scenario implemented increases the city’s fire station coverage from 58.6 percent to 85.9 percent, based on a five-minute response time, with an implementation plan that spans three years

Mathematical Models in Humanitarian Supply Chain Management: A Systematic Literature Review

In the past decade the humanitarian supply chain (HSC) has attracted the attention of researchers due to the increasing frequency of disasters. The uncertainty in time, location, and severity of disaster during predisaster phase and poor conditions of available infrastructure during postdisaster phase make HSC operations difficult to handle. In order to overcome the difficulties during these phases, we need to assure that HSC operations are designed in an efficient manner to minimize human and economic losses. In the recent times, several mathematical optimization techniques and algorithms have been developed to increase the efficiency of HSC operations. These techniques and algorithms developed for the field of HSC motivate the need of a systematic literature review. Owing to the importance of mathematical modelling techniques, this paper presents the review of the mathematical contributions made in the last decade in the field of HSC. A systematic literature review methodology is used for this paper due to its transparent procedure. There are two objectives of this study: the first one is to conduct an up-to-date survey of mathematical models developed in HSC area and the second one is to highlight the potential research areas which require attention of the researchers