The simulation of a public hospital emergency department and efficiency evaluation with data envelopment analysis

Hospital emergency rooms have very important role in the hospital organization. The working based on 24 hours, the uncertainty of patient's arrivals and patient's types, having different subunits (laboratory, X-Ray et al.) and finally the necessity to respond to patients as soon as possible affect the quality of emergency rooms directly. Furthermore, the intensive and stressful working conditions pin down a detailed emergency working plan which take the consideration employee satisfaction in addition to patient satisfaction. In this study, a discrete event simulation model has been developed for the purpose to evaluate the current situation of a public hospital emergency room. The simulation model results which are related to current situation were analyzed and then alternative scenarios that reduce patient average length of stay in the system, increase number of patients served in unit time (improve patient throughput) and finally provide to use resources effectively were aimed to developed. When scenarios have been developed, the opinions of emergency staff were taken and at the same time the constraints of hospital which are financial, staff, location and other resources were taken into consideration. Current situation of the system and each of the alternative 10 scenarios were accepted as Decision Making Unit for efficiency analysis. Data Envelopment Analysis (DEA) was used as method to obtain the efficiency scores. According to input oriented DEA models, the scenarios which are effective were tried to determined. Keywords: "Emergency Room", "Simulation Modeling", "Efficiency", "Data Envelopment Analysis", "Alternative Scenario".