A Hybrid Fuzzy Multi-criteria Decision Making Model to Evaluate the Overall Performance of Public Emergency Departments: A Case Study

[EN] Performance evaluation is relevant for supporting managerial decisions related to the improvement of public emergency departments (EDs). As different criteria from ED context and several alternatives need to be considered, selecting a suitable Multicriteria Decision-Making (MCDM) approach has become a crucial step for ED performance evaluation. Although some methodologies have been proposed to address this challenge, a more complete approach is still lacking. This paper bridges this gap by integrating three potent MCDM methods. First, the Fuzzy Analytic Hierarchy Process (FAHP) is used to determine the criteria and sub-criteria weights under uncertainty, followed by the interdependence evaluation via fuzzy Decision-Making Trial and Evaluation Laboratory(FDEMATEL). The fuzzy logic is merged with AHP and DEMATEL to illustrate vague judgments. Finally, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) is used for ranking EDs. This approach is validated in a real 3-ED cluster. The results revealed the critical role of Infrastructure (21.5%) in ED performance and the interactive nature of Patient safety (C+R =12.771). Furthermore, this paper evidences the weaknesses to be tackled for upgrading the performance of each ED.Ortiz-Barrios, M.; Alfaro Saiz, JJ. (2020). A Hybrid Fuzzy Multi-criteria Decision Making Model to Evaluate the Overall Performance of Public Emergency Departments: A Case Study. International Journal of Information Technology & Decision Making. 19(6):1485-1548. https://doi.org/10.1142/S0219622020500364S14851548196Lord, K., Parwani, V., Ulrich, A., Finn, E. B., Rothenberg, C., Emerson, B., … Venkatesh, A. K. (2018). Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. The American Journal of Emergency Medicine, 36(7), 1246-1248. doi:10.1016/j.ajem.2018.03.043Sørup, C. M., Jacobsen, P., & Forberg, J. L. (2013). 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Development of emergency response systems by intelligent and integrated approaches for marine oil spill accidents

Oil products play a pervasive role in modern society as one of the dominant energy fuel sources. Marine activities related to oil extraction and transportation play a vital role in resource supply. However, marine oil spills occur due to such human activities or harsh environmental factors. The emergency accidents of spills cause negative impacts on the marine environment, human health, and economic loss. The responses to marine oil spills, especially large-scale spills, are relatively challenging and inefficient due to changing environmental conditions, limited response resources, various unknown or uncertain factors and complex resource allocation processes. The development of previous research mainly focused on single process simulation, prediction, or optimization (e.g., oil trajectory, weathering, or cleanup optimization). There is still a lack of research on comprehensive and integrated emergency responses considering multiple types of simulations, types of resource allocations, stages of accident occurrence to response, and criteria for system optimizations. Optimization algorithms are an important part of system optimization and decision-making. Their performance directly affacts the quality of emergency response systems and operations. Thus, how to improve efficiency of emergency response systems becomes urgent and essential for marine oil spill management. The power and potential of integrating intelligent-based modeling of dynamic processes and system optimization have been recognized to better support oil spill responders with more efficient response decisions and planning tools. Meanwhile, response decision-making combined with human factor analysis can help quantitatively evaluate the impacts of multiple causal factors on the overall processes and operational performance after an accident. To address the challenges and gaps, this dissertation research focused on the development and improvement of new emergency response systems and their applications for marine oil spill response in the following aspects: 1) Realization of coupling dynamic simulation and system optimization for marine oil spill responses - The developed Simulation-Based Multi-Agent Particle Swarm Optimization (SA-PSO) modeling investigated the capacity of agent-based modeling on dynamic simulation of spill fate and response, particle swarm optimization on response allocation with minimal time and multi-agent system on information sharing. 2) Investigation of multi-type resource allocation under a complex simulation condition and improvement of optimization performance - The improved emergency response system was achieved by dynamic resource transportation, oil weathering and response simulations and resource allocation optimization. The enhanced particle swarm optimization (ME-PSO) algorithm performed outstanding convergence performance and low computation cost characteristics integrating multi-agent theory (MA) and evolutionary population dynamics (EPD). 3) Analysis and evaluation of influencing factors of multiple stages of spill accidents based on human factors/errors and multi-criteria decision making - The developed human factors analysis and classification system for marine oil spill accidents (HFACS-OS) framework qualitatively evaluated the influence of various factors and errors associated with the multiple operational stages considered for oil spill preparedness and response (e.g., oil spill occurrence, spill monitoring, decision making/contingency planning, and spill response). The framework was further coupled with quantitative data analysis by Fuzzy-based Technique for Order Preference by Similarity to Idea Solution (Fuzzy-TOPSIS) to enhance decision-making during response operations under multiple criteria. 4) Development of a multi-criteria emergency response system with the enhanced optimization algorithm, multi-mode resource transportation and allocation and a more complex and realistic simulation modelling - The developed multi-criteria emergency response system (MC-ERS) system integrated dynamic process simulations and weighted multi-criteria system optimization. Total response time, response cost and environmental impacts were regarded as multiple optimization goals. An improved weighted sum optimization function was developed to unify the scaling and proportion of different goals. A comparative PSO was also developed with various algorithm-improving methods and the best-performing inertia weight function. The proposed emergency response approaches in studies were examined by oil spill case studies related to the North Atlantic Ocean and Canada circumstances to analyze the modelling performance and evaluate their practicality and applicability. The developed optimization algorithms were tested by benchmarked functions, other optimization algorithms, and an oil spill case. The developed emergency response systems and the contained simulation and optimization algorithms showed the strong capability for decision-making and emergency responses by recommending optimal resource management or evaluations of essential factors. This research was expected to provide time-efficient, and cost-saving emergency response management approaches for handling and managing marine oil spills. The research also improved our knowledge of the significance of human factors/errors to oil spill accidents and response operations and provided improved support tools for decision making. The dissertation research helped fill some important gaps in emergency response research and management practice, especially in marine oil spill response, through an innovative integration of dynamic simulation, resource optimization, human factor analysis, and artificial intelligence methods. The research outcomes can also provide methodological support and valuable references for other fields that require timely and effective decisions, system optimizations, process controls, planning and designs under complicated conditions, uncertainties, and interactions

Decision making study: methods and applications of evidential reasoning and judgment analysis

Decision making study has been the multi-disciplinary research involving operations researchers, management scientists, statisticians, mathematical psychologists and economists as well as others. This study aims to investigate the theory and methodology of decision making research and apply them to different contexts in real cases. The study has reviewed the literature of Multiple Criteria Decision Making (MCDM), Evidential Reasoning (ER) approach, Naturalistic Decision Making (NDM) movement, Social Judgment Theory (SJT), and Adaptive Toolbox (AT) program. On the basis of these literatures, two methods, Evidence-based Trade-Off (EBTO) and Judgment Analysis with Heuristic Modelling (JA-HM), have been proposed and developed to accomplish decision making problems under different conditions. In the EBTO method, we propose a novel framework to aid people s decision making under uncertainty and imprecise goal. Under the framework, the imprecise goal is objectively modelled through an analytical structure, and is independent of the task requirement; the task requirement is specified by the trade-off strategy among criteria of the analytical structure through an importance weighting process, and is subject to the requirement change of a particular decision making task; the evidence available, that could contribute to the evaluation of general performance of the decision alternatives, are formulated with belief structures which are capable of capturing various format of uncertainties that arise from the absence of data, incomplete information and subjective judgments. The EBTO method was further applied in a case study of Soldier system decision making. The application has demonstrated that EBTO, as a tool, is able to provide a holistic analysis regarding the requirements of Soldier missions, the physical conditions of Soldiers, and the capability of their equipment and weapon systems, which is critical in domain. By drawing the cross-disciplinary literature from NDM and AT, the JA-HM extended the traditional Judgment Analysis (JA) method, through a number of novel methodological procedures, to account for the unique features of decision making tasks under extreme time pressure and dynamic shifting situations. These novel methodological procedures include, the notion of decision point to deconstruct the dynamic shifting situations in a way that decision problem could be identified and formulated; the classification of routine and non-routine problems, and associated data alignment process to enable meaningful decision data analysis across different decision makers (DMs); the notion of composite cue to account for the DMs iterative process of information perception and comprehension in dynamic task environment; the application of computational models of heuristics to account for the time constraints and process dynamics of DMs decision making process; and the application of cross-validation process to enable the methodological principle of competitive testing of decision models. The JA-HM was further applied in a case study of fire emergency decision making. The application has been the first behavioural test of the validity of the computational models of heuristics, in predicting the DMs decision making during fire emergency response. It has also been the first behavioural test of the validity of the non-compensatory heuristics in predicting the DMs decisions on ranking task. The findings identified extend the literature of AT and NDM, and have implications for the fire emergency decision making

A Comparative Study of MCDM Methods Integrated with Rapid Visual Seismic Vulnerability Assessment of Existing RC Structures

Recently, the demand for residence and usage of urban infrastructure has been increased, thereby resulting in the elevation of risk levels of human lives over natural calamities. The occupancy demand has rapidly increased the construction rate, whereas the inadequate design of structures prone to more vulnerability. Buildings constructed before the development of seismic codes have an additional susceptibility to earthquake vibrations. The structural collapse causes an economic loss as well as setbacks for human lives. An application of different theoretical methods to analyze the structural behavior is expensive and time-consuming. Therefore, introducing a rapid vulnerability assessment method to check structural performances is necessary for future developments. The process, as mentioned earlier, is known as Rapid Visual Screening (RVS). This technique has been generated to identify, inventory, and screen structures that are potentially hazardous. Sometimes, poor construction quality does not provide some of the required parameters; in this case, the RVS process turns into a tedious scenario. Hence, to tackle such a situation, multiple-criteria decision-making (MCDM) methods for the seismic vulnerability assessment opens a new gateway. The different parameters required by RVS can be taken in MCDM. MCDM evaluates multiple conflicting criteria in decision making in several fields. This paper has aimed to bridge the gap between RVS and MCDM. Furthermore, to define the correlation between these techniques, implementation of the methodologies from Indian, Turkish, and Federal Emergency Management Agency (FEMA) codes has been done. The effects of seismic vulnerability of structures have been observed and compared

Location Models of Emergency Service Public Facilities with Special Reference to the Strategic Planning of Fire Service Provision

The mam mm of this research is to develop a framework for both the location/allocation and planning/management of emergency services/facilities. The research explores the most suitable models for these facilities taking into account both equity and efficiency. This research also explores holV policy-based planning/management should be carried out with particular reference to fire services/stations but partially also to rescue/emergency medical services. We apply location/allocation models and decision-making models for these perspectives based on a variety of analyses of emergency services/facilities. The former relate to coverage models such as traditional p-median models (PMM) and modified maximal coverage models (MCM); .the latter relate to multiple criteria (attribute) decision-making models (MCDMlMADM) using TOPSIS (entropy method) and AHP (HAW) methods. In applying these models, we basically take into consideration the characteristics of emergency services/facilities, planning criteria, delivery systems, and the results of statistical data analysis and questionnaire survey. This is to explore which critical factors influence the location/allocation of emergency facilities and how they are applied to the models and the case study area. This research draws on the results of the model application and explores how to manage the much extended emergency services that now include rescue and emergency medical services. As a result of this model application, we first of all found that response time and population were most critical to location/allocation models and the MCM is most suited to the case study area in terms of efficiency and equity. In the evaluation of models, we also found that backup and workload problems were critical and should be evaluated when the service equipment and manpower were busy. Secondly, we found that the MADM would be useful to overcome the disadvantages of coverage models which mainly focus on accessibility dependent upon the response time. This MADM enabled to provide improvements in service quality to be provided by taking into consideration a variety of variables such as fire incidence, manpower, equipment, and cooperation with other agencies. In addition, policy-based planning and management were required so that the models can be effective in reality. Therefore, we explored recent technologies and techniques to enable decision-makers to make emergency service delivery much more efficient. As a result, we found that recent communication equipment and spatial information systems raised the possibilities of substantial improvements in management, planning skills, and service quality as well as a means of exploring optimum location/allocation. This was intended to overcome the service management problems of both location/allocation methods and decision-making methods. In conclusion, we recommend equitable and efficient location/allocation models such as coverage models suitable for the areas more remote from inner cities. We strongly recommend multiattribute decision making models to take into account a range of variables resulting from emergency services that have recently much more diversified and extended. Corresponding to rapidly changing technologies in service delivery systems, we need to establish effective policies/strategies and develop new techniques/skills for fire/rescue and emergency planning and management. In addition, these policies and techniques/skills are intended for fire experts, research scientists, planners, administrators, policy-makers, and legislators. We suggest an integrated approach both for both urban planning and for emergency service planning/management in the hope that an integrated system of fire and rescue services (FRS) and emergency medical services (EMS) will be able to save properties and lives

The National Criteria for Evacuation Decision-Making in Nursing Homes

Explains the key factors nursing home administrators and healthcare workers must consider in deciding whether to evacuate patients or to shelter them in place during natural disasters. Includes guidelines for drawing up emergency management plans

Shipboard Crisis Management: A Case Study.

The loss of the "Green Lily" in 1997 is used as a case study to highlight the characteristics of escalating crises. As in similar safety critical industries, these situations are unpredictable events that may require co-ordinated but flexible and creative responses from individuals and teams working in stressful conditions. Fundamental skill requirements for crisis management are situational awareness and decision making. This paper reviews the naturalistic decision making (NDM) model for insights into the nature of these skills and considers the optimal training regimes to cultivate them. The paper concludes with a review of the issues regarding the assessment of crisis management skills and current research into the determination of behavioural markers for measuring competence

Architecture of Environmental Risk Modelling: for a faster and more robust response to natural disasters

Demands on the disaster response capacity of the European Union are likely to increase, as the impacts of disasters continue to grow both in size and frequency. This has resulted in intensive research on issues concerning spatially-explicit information and modelling and their multiple sources of uncertainty. Geospatial support is one of the forms of assistance frequently required by emergency response centres along with hazard forecast and event management assessment. Robust modelling of natural hazards requires dynamic simulations under an array of multiple inputs from different sources. Uncertainty is associated with meteorological forecast and calibration of the model parameters. Software uncertainty also derives from the data transformation models (D-TM) needed for predicting hazard behaviour and its consequences. On the other hand, social contributions have recently been recognized as valuable in raw-data collection and mapping efforts traditionally dominated by professional organizations. Here an architecture overview is proposed for adaptive and robust modelling of natural hazards, following the Semantic Array Programming paradigm to also include the distributed array of social contributors called Citizen Sensor in a semantically-enhanced strategy for D-TM modelling. The modelling architecture proposes a multicriteria approach for assessing the array of potential impacts with qualitative rapid assessment methods based on a Partial Open Loop Feedback Control (POLFC) schema and complementing more traditional and accurate a-posteriori assessment. We discuss the computational aspect of environmental risk modelling using array-based parallel paradigms on High Performance Computing (HPC) platforms, in order for the implications of urgency to be introduced into the systems (Urgent-HPC).Comment: 12 pages, 1 figure, 1 text box, presented at the 3rd Conference of Computational Interdisciplinary Sciences (CCIS 2014), Asuncion, Paragua