An Agent-Based Decision Support System for Hospitals Emergency Departments

AbstractModeling and simulation have been shown to be useful tools in many areas of the Healthcare operational management, field in which there is probably no area more dynamic and complex than hospital emergency departments (ED). This paper presents the results of an ongoing project that is being carried out by the Research Group in Individual Oriented Modeling (IoM) of the University Autonoma of Barcelona (UAB) with the participation of Hospital of Sabadell ED Staff Team. Its general objective is creating a simulator that, used as decision support system (DSS), aids the heads of the ED to make the best informed decisions possible. The defined ED model is a pure Agent-Based Model, formed entirely of the rules governing the behavior of the individual agents which populate the system. Two distinct types of agents have been identified, active and passive. Active agents represent human actors, meanwhile passive agents represent services and other reactive systems. The actions of agents and the communication between them will be represented using Moore state machines extended to include probabilistic transitions. The model also includes the environment in which agents move and interact. With the aim of verifying the proposed model an initial simulation has been created using NetLogo, an agent-based simulation environment well suited for modeling complex systems

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2011

Highlights examples of preparedness programs and capacities at risk of federal budget cuts or elimination, examines state and local public health budget cuts, reviews ten years of progress and shortfalls, and outlines policy issues and recommendations

A survey of health care models that encompass multiple departments

In this survey we review quantitative health care models to illustrate the extent to which they encompass multiple hospital departments. The paper provides general overviews of the relationships that exists between major hospital departments and describes how these relationships are accounted for by researchers. We find the atomistic view of hospitals often taken by researchers is partially due to the ambiguity of patient care trajectories. To this end clinical pathways literature is reviewed to illustrate its potential for clarifying patient flows and for providing a holistic hospital perspective

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2009

Based on ten indicators, assesses progress in the readiness of states, federal government, and hospitals to respond to public health emergencies, with a focus on the H1N1 flu. Outlines improvements and concerns in funding, accountability, and other areas

When Terrorism Threatens Health: How Far are Limitations on Personal and Ecomonic Liberties Justified

The government is engaged in a homeland-security project to safeguard the population\u27s health from potential terrorist attacks. This project is politically charged because it affords the state enhanced powers to restrict personal and economic liberties. Just as governmental powers relating to intelligence, law enforcement, and criminal justice curtail individual interests, so too do public health powers

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2008

Examines ten indicators to assess progress in state readiness to respond to bioterrorism and other public health emergencies. Evaluates the federal government's and hospitals' preparedness. Makes suggestions for funding, restructuring, and other reforms

Walla Walla General Hospital: Setting Staff Up for Success in Pneumonia Care

Outlines education and reinforcement strategies, including building a quality culture and implementing a hospitalist program, standardized order sets, and staff supports, that enable high performance on pneumonia care core measures. Lists lessons learned

Healthcare Ethics During a Pandemic

As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives? With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel  struggle with acute shortages of equipment—both to treat patients and  protect themselves. With their personal and possibly their family’s lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks—including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers’ risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal