Scheduling Approch to Control the Execution of the Patient Pathway Workflow in the Emergency Department

The majority of developed countries are interested in enhancing their healthcare information system in order to expect the overcrowding situations and improve the patient quality of care. In this paper, we focus on the patient pathway workflow modeling using the business process management notation (BPMN) graphical language in the adult emergency department (AED). The goal of our work is to identify the dysfunction situations and improve the performance indicators such as the waiting time. The idea is to optimize this criterion using a real-time scheduling algorithm applied simultaneously on each decision point (gateway) of the patient pathway workflow model. The objective of our algorithm is to assign a dynamic priority to the patients according to their health state evolution. In addition, taking into account the uncertainty of patient arrival an adequate a real time scheduling algorithm is proposed. Our approach is tested on a set of real database from the AED of the regional university hospital (RUH) of Lille (in the north of France). We conducted interviews, performed healthcare tasks analysis, and validated results with the AED medical staff. The goal is to have the workflow model as close as possible to the real functioning of the AED. The simulation results show that the average waiting time of the patients at the AED drop by 11% thanks to our approach.