Hospital selection decision in emergency medical services: a simulation-based assessment of assignment criteria

ABSTRACT

Emergency Medical Services play a fundamental societal role since they provide pre-hospital care to patients in critical and time-constrained conditions. In this context, the hospital selection decision is vital to respond in a timely, effective and efficient way. By means of simulation experiments, the present study compares the effects of different assignment logics against a set of performance dimensions. To this end, we develop a Discrete Event Simulation model that covers the entire Emergency Medical Service process, from the ambulance transportation to final departure of the patient from the Emergency Department. Results demonstrate that the use of effectiveness-related criteria (e.g. expected waiting time, resource saturation) significantly enhances the overall performance and, at the same time, guarantees higher quality of care. Thus, the study contributes in enhancing hospital selection decisions by supporting decision-makers through a comprehensive decisional model, distancing from prior researches that predominantly considered efficiency-driven criteria (i.e. proximity).

KEYWORDS:

• Emergency medical service
• hospital selection decision
• discrete event simulation
• performance measurement
• decision support system

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Daniela Tedesco

Daniela Tedesco is a management engineer with industrial management specialization. She carries out research in the field of Risk and Resilience of Complex Systems, with particular emphasis in the healthcare sector. She currently works for a leading general hospital in Milan, Italy. Her skills focus on the assessment of Emergency Management capabilities, Business Continuity Management, Enterprise Risk Management, Quality Management and Risk Management in the healthcare sector.

Giada Feletti

Giada Feletti is management engineer with industrial management specialization. She currently works as a Research Fellow at Polytechnic of Milan (Management Engineering Department) developing projects related to critical infrastructure resilience and emergency management. She is also working as a consultant in the fields of business continuity and operational resilience.

Paolo Trucco

Paolo Trucco is Full Professor of Industrial Risk Management and Director of the PhD Program in Management Engineering at Polytechnic of Milan. He is technical advisor of DG Home Affairs (EC) on Critical Infrastructure Protection Actions, he is also advisor of the Lombardy Region Government in the Critical Infrastructure Resilience and Healthcare Risk Management committees. He is member of ESRA (the European Safety and Reliability Association), and founder member of CIRINT.NET (the Critical Infrastructure Resilience International Network) and of the Italian Chapter of TIEMS (The International Emergency Management Society).