Cubic chromosome representation for patients' scheduling in the emergency department

In healthcare institution management, hospital flow control and the prediction of overcrowding are major issues. The objective of the present study is to develop a dynamic scheduling protocol that minimizes interference between scheduled and unscheduled patients arriving at the emergency department (ED) while taking account of disturbances that occur in the ED on a daily basis. The ultimate goal is to improve the quality of care and reduce waiting times via a two-phase scheduling approach. In the first phase, we used a genetic algorithm (based on a three-dimensional cubic chromosome) to manage scheduled patients. In the second phase, we took account of the dynamic, uncertain nature of the ED environment (the arrival of unscheduled patients) by continuously updating the schedule.