SIM-UTA: evaluating reorganisation scenarios in a healthcare organisation

Hospitals across the globe face the challenge to respond to public demand for more effective and transparent healthcare services. In order to optimise the services provided by hospital organisations, several methodological approaches have been developed in the operational research domain. The aim of this paper is to present a new methodology for the improvement of healthcare services in an emergency department of a hospital. The proposed SIM-UTA approach combines simulation techniques and MCDA tools (UTASTAR method) in order to help the management of the hospital to optimise specific aspects of the emergency department's operation. In order to illustrate the applicability of the methodological approach, a real-word case study in a Greek hospital is presented. The results show that the most important factor for the emergency department is the total length of stay, while the evaluation of several alternative reforms underline that the implementation of a fast track unit may give significant improvements. SIM-UTA may serve as useful tools for decision support, taking into account several factor, like working loads, waiting times, length of stay, etc.