An Integer Programming Model for the Dynamic Location and Relocation of Emergency Vehicles: A Case Study

In this paper, we address the dynamic Emergency Medical Service (EMS) systems. A dynamic location model is presented that tries to locate and relocate the ambulances. The proposed model controls the movements and locations of ambulances in order to provide a better coverage of the demand points under different fluctuation patterns that may happen during a given period of time. Some numerical experiments have been carried out by using some real-world data sets that have been collected through the French EMS system.Comment: Proceedings of the 12th International Symposium on Operational Research (SOR'2013), Slovenia, September 2013, pp. 343-350, (2013

A taxonomy for emergency service station location problem

The emergency service station (ESS) location problem has been widely studied in the literature since 1970s. There has been a growing interest in the subject especially after 1990s. Various models with different objective functions and constraints have been proposed in the academic literature and efficient solution techniques have been developed to provide good solutions in reasonable times. However, there is not any study that systematically classifies different problem types and methodologies to address them. This paper presents a taxonomic framework for the ESS location problem using an operations research perspective. In this framework, we basically consider the type of the emergency, the objective function, constraints, model assumptions, modeling, and solution techniques. We also analyze a variety of papers related to the literature in order to demonstrate the effectiveness of the taxonomy and to get insights for possible research directions

Ambulance Emergency Response Optimization in Developing Countries

The lack of emergency medical transportation is viewed as the main barrier to the access of emergency medical care in low and middle-income countries (LMICs). In this paper, we present a robust optimization approach to optimize both the location and routing of emergency response vehicles, accounting for uncertainty in travel times and spatial demand characteristic of LMICs. We traveled to Dhaka, Bangladesh, the sixth largest and third most densely populated city in the world, to conduct field research resulting in the collection of two unique datasets that inform our approach. This data is leveraged to develop machine learning methodologies to estimate demand for emergency medical services in a LMIC setting and to predict the travel time between any two locations in the road network for different times of day and days of the week. We combine our robust optimization and machine learning frameworks with real data to provide an in-depth investigation into three policy-related questions. First, we demonstrate that outpost locations optimized for weekday rush hour lead to good performance for all times of day and days of the week. Second, we find that significant improvements in emergency response times can be achieved by re-locating a small number of outposts and that the performance of the current system could be replicated using only 30% of the resources. Lastly, we show that a fleet of small motorcycle-based ambulances has the potential to significantly outperform traditional ambulance vans. In particular, they are able to capture three times more demand while reducing the median response time by 42% due to increased routing flexibility offered by nimble vehicles on a larger road network. Our results provide practical insights for emergency response optimization that can be leveraged by hospital-based and private ambulance providers in Dhaka and other urban centers in LMICs

Real-time ambulance relocation: Assessing real-time redeployment strategies for ambulance relocation

Providers of Emergency Medical Services (EMS) are typically concerned with keeping response times short. A powerful means to ensure this, is to dynamically redistribute the ambulances over the region, depending on the current state of the system. In this paper, we provide new insight into how to optimally (re)distribute ambulances. We study the impact of (1) the frequency of redeployment decision moments, (2) the inclusion of busy ambulances in the state description of the system, and (3) the performance criterion on the quality of the distribution strategy. In addition, we consider the influence of the EMS crew workload, such as (4) chain relocations and (5) time bounds, on the execution of an ambulance relocation. To this end, we use trace-driven simulations based on a real dataset from ambulance providers in the Netherlands. In doing so, we differentiate between rural and urban regions, which typically face different challenges when it comes to EMS. Our results show that: (1) taking the classical 0-1 performance criterion for assessing the fraction of late arrivals only differs slightly from related response time criteria for evaluating the performance as a function of the response time, (2) adding more relocation decision moments is highly beneficial, particularly for rural areas, (3) considering ambulances involved in dropping off patients available for newly coming incidents reduces relocation times only slightly, and (4) simulation experiments for assessing move-up policies are highly preferable to simple mathematical models

STRATEGIES TO IMPROVE THE EFFICIENCY OF EMERGENCY MEDICAL SERVICE (EMS) SYSTEMS UNDER MORE REALISTIC CONDITIONS

Emergency medical service (EMS) systems provide medical care to pre-hospital patients who need rapid response and transportation. This dissertation proposes a new realistic approach for EMS systems in two major focuses: multiple unit dispatching and relocation strategies. This work makes recommendations for multiple-unit dispatch to multiple call priorities based on simulation optimization and heuristics. The objective is to maximize the expected survival rate. Simulation models are proposed to determine the optimization. A heuristic algorithm is developed for large-scale problems. Numerical results show that dispatching while considering call priorities, rather than always dispatching the closest medical units, could improve the effectiveness of EMS systems. Additionally, we extend the model of multiple-unit dispatch to examine fairness between call priorities. We consider the potentially-life-threatening calls which could be upgraded to life-threatening. We formulate the fairness problem as an integer programming model solved using simulation optimization. Taking into account fairness between priorities improves the performance of EMS systems while still operating at high efficiency. As another focus, we consider dynamic relocation strategy using a nested-compliance table policy. For each state of the EMS systems, a decision must be made regarding exactly which ambulances will be allocated to which stations. We determine the optimal nested-compliance table in order to maximize the expected coverage, in the binary sense, as will be later discussed. We formulate the nested-compliance table model as an integer program, for which we approximate the steady-state probabilities of EMS system to use as parameters to our model. Simulation is used to investigate the performance of the model and to compare the results to a static policy based on the adjusted maximum expected covering location problem (AMEXCLP). Additionally, we extend the nested-compliance table model to consider an upper bound on relocation time. We analyze the decision regarding how to partition the service area into smaller sub-areas (districts) in which each sub-area operates independently under separate relocation strategies. We embed the nested-compliance table model into a tabu search heuristic algorithm. Iteration is used to search for a near-optimal solution. The performance of the tabu search heuristic and AMEXCLP are compared in terms of the realized expected coverage of EMS systems

The Minimum Expected Penalty Relocation Problem for the computation of compliance tables for ambulance vehicles

We study the ambulance relocation problem in which one tries to respond to possible future incidents quickly. For this purpose, we consider compliance table policies: a relocation strategy commonly used in practice. Each compliance table level indicates the desired waiting site locations for the available ambulances. To compute efficient compliance tables, we introduce the minimum expected penalty relocation problem (MEXPREP), which we formulate as an integer linear program. In this problem, one has the ability to control the number of waiting site relocations. Moreover, different performance measures related to response times, such as survival probabilities, can be incorporated. We show by simulation that the MEXPREP compliance tables outperform both the static policy and compliance tables obtained by the maximal expected coverage relocation problem (MECRP), which both serve as benchmarks. Besides, we perform a study on different relocation thresholds and on two different methods to assign available ambulances to desired waiting sites

Optimization approaches to the ambulance dispatching and relocation problem

In the Emergency Medical Service (EMS) context, the decision-making process plays a very important role since some decisions highly impact patients’ health. This thesis focuses on the operational level by solving the dispatching and relocation ambulance problems. Dispatching decisions assign ambulances to emergencies, and the relocation problem decides to which base ambulances should be (re)assigned. Two optimization approaches are proposed to improve the effectiveness and efficiency in the EMS response: a mixed-integer linear programming (MILP) model and a pilot method heuristic. The aim is to maximize the system’s coverage using a time-preparedness measure allowing relocations to any base. Experiments are performed using EMS data from Lisbon, Portugal, where solving these problems is still a handmade task. Different ambulance types are considered, which should be used according to the severity of each emergency. The proposed approaches are tested under different scenarios: varying the period size, varying the number of emergencies, and simulating a whole day. Furthermore, they are adapted to compare the proposed strategy with the current Portuguese EMS strategy, which dispatches the closest available ambulance for each emergency and always relocates ambulances to their home bases. Results highlight the potential of the mathematical model and of the proposed strategy to be applied in realtime contexts since a reduction of 10% is obtained in the average response time to emergencies in the simulation scenario. The heuristic should be used when more emergencies occur in the same time period since a solution can be obtained almost immediately in contrast to the MILP usage. To help EMS managers in the decision-making process, we propose an ambulance management tool using Geographic Information Systems, which embeds the proposed approaches. It can be used in real-time or for simulation purposes. It incorporates a map visualization that analyzes ambulances’ movements on the map and the emergencies’ location

A Chance Constrained Programming Model for Reliable Emergency Vehicles Relocation Problem

AbstractEmergency vehicles relocation is one mechanism of increasing preparedness for potential emergencies. This paper addresses the problem of designing reliable emergency vehicles relocation system. Under this respect, we extend the DYNACO model with chance-constrained programming framework for the optimal redeployment of emergency vehicles. The model deals with the availability of emergency vehicles by approximate hypercube. In addition, other random elements including travel time and emergency demand are taken into account in the model. Solution procedure based on genetic algorithm and Monte-Carlo simulation is developed to solve the stochastic model. Computational experiences are reported to illustrate the performance and the effectiveness of the proposed solution

The Incremental Cooperative Design of Preventive Healthcare Networks

This document is the Accepted Manuscript version of the following article: Soheil Davari, 'The incremental cooperative design of preventive healthcare networks', Annals of Operations Research, first published online 27 June 2017. Under embargo. Embargo end date: 27 June 2018. The final publication is available at Springer via http://dx.doi.org/10.1007/s10479-017-2569-1.In the Preventive Healthcare Network Design Problem (PHNDP), one seeks to locate facilities in a way that the uptake of services is maximised given certain constraints such as congestion considerations. We introduce the incremental and cooperative version of the problem, IC-PHNDP for short, in which facilities are added incrementally to the network (one at a time), contributing to the service levels. We first develop a general non-linear model of this problem and then present a method to make it linear. As the problem is of a combinatorial nature, an efficient Variable Neighbourhood Search (VNS) algorithm is proposed to solve it. In order to gain insight into the problem, the computational studies were performed with randomly generated instances of different settings. Results clearly show that VNS performs well in solving IC-PHNDP with errors not more than 1.54%.Peer reviewe