Improving the emergency department performance using simulation and MCDM methods

The main purpose of this paper is to introduce a new framework to more efficiently investigate the patient flow of the Emergency Department (ED) of a governmental hospital in Tehran, Iran, in order to find out improving scenarios for reducing waiting times of patients. The proposed framework integrates the simulation model of patients flow process with the group AHP and TOPSIS decision models in order to evaluate and rank scenarios based upon desired performance measures. TOPSIS decision model takes the weights of performance measures from the group AHP and the values of performance measures from simulation model, and ranks the improving scenarios. The results analysis indicates that the average waiting time of non-fast-track patients by taking new policies with reasonable expenditure can be reduced by 42.3%.