Improved System Design of an Emergency Department through Simulation-Based Multi-Objective Optimization

Enrique Ruiz Zúñiga


A University of Skövde researcher studied the organization of the Emergency Department (ED) of the Hospital of Skövde on how to best meet the requirements established by the County Council concerning waiting-time for triage, physician examination and total lead time though the system.

The research sought to maximize the service level of the ED and to reach the previous aims by:

  • Reducing waiting time of patients
  • Increasing the use and efficiency of the existing resources


The simulation of the system was created with Flexsim Healthcare to analyze the ED performance in ambulance and walking patients flows, crossing with other department flows and presenting different triage levels. After the verification of resources’ shift, doctors’ occupation and patient classifications along with waiting-time validation, the research defined different scenarios and automatically analyzed their impact with modeFRONTIER


modeFRONTIER enabled an intelligent what-if analysis of a model with many different input parameters having complex correlations and conflicting objective functions. The three objectives of the ED were reached and the waiting time for the first meeting with a doctor was reduced by 60% for all the patients. With this approach researchers could identify feasible and optimal alternatives to design, maintain and improve a complex and stochastic healthcare processes.