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An Operations Research Approach for Daily Emergency Management
Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
2019 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Emergency services play a vital role in society by providing help to affected people and minimizing damage to public and private assets as well as the environment during emergencies. However, these organizations deal with problems of increasing demand uncertainty and resource shortage over time. These problems lead to the creation of many other problems, such as longer response times, lower survivability of victims and patients, and more severe damage to properties and the environment. Acquiring more information about future emergency demand, such as factors affecting this demand, can contribute to reduction of the effects of increasing demand uncertainty. The introduction of volunteers as a new type of emergency resource, which has gained attention in the past few years, can be a solution to the problem of increasing resource shortage.

The aim of this thesis is to provide operations research-based models and methods that can assist medical emergency services in daily emergency management. The aim is supported by two objectives: 1) to develop a forecasting model and 2) to develop models for the dispatch of volunteers. Three separate studies with a focus on these objectives are conducted, and the results are described in three papers.

In the first paper, a forecasting model for predicting the volume of ambulance calls per hour and geographic location for three counties in Sweden is presented. The model takes into consideration geographical zones with few or no population and very low call frequency. Comparative results based on the real data of ambulance calls show that the proposed model performs better than the model that is currently used in some parts of Sweden for operational and tactical planning of emergency medical services. In addition to performance improvement, the proposed model provides information about the factors affecting ambulance demand.

In the second paper, the use of volunteers in response to out-of-hospital cardiac arrest (OHCA) cases is considered, and a deterministic optimization model for their dispatch is provided. The model benefits from a survival function for determining dispatch decisions. The effect of arrival times of volunteers on the survivability of patients is also considered. The results show that, in terms of achieved survivability of patient based on the applied survival function, the proposed model performs better than simple decision rules used today.

The third paper presents a probabilistic method for the dispatch of volunteers to OHCA cases. This method considers the uncertainties associated with the actions of volunteers once they are assigned a task. The proposed method uses a survival function as the objective of dispatch decisions. The results of the method are compared to the static dispatch method that is currently used in an operational system in Sweden for the utilization of volunteers in OHCA cases. Comparative results based on real data show that, with respect to used survival function, the proposed method contributes to higher survivability of OHCA patients than the static dispatch method.

The models and method in this thesis focus on solving real-world problems and use real data for that purpose when available. Some simplifications were considered in the development process. Nevertheless, these models and method have the potential to be beneficial for medical emergency services in practice and can be used as a base for dynamic resource management systems. Such systems can be helpful for both tactical and operational planning of emergency resources.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. , p. 47
Series
Linköping Studies in Science and Technology. Licentiate Thesis, ISSN 0280-7971 ; 1842
National Category
Transport Systems and Logistics Computer and Information Sciences Communication Studies
Identifiers
URN: urn:nbn:se:liu:diva-157099DOI: 10.3384/lic.diva-157099ISBN: 9789176850589 (print)OAI: oai:DiVA.org:liu-157099DiVA, id: diva2:1318572
Presentation
2019-06-10, K3, Kåkenhus, Campus Norrköping, Linköpings universitet, Norrköping, 13:15 (English)
Opponent
Supervisors
Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-05-29Bibliographically approved
List of papers
1. Forecasting the Demand for Emergency Medical Services
Open this publication in new window or tab >>Forecasting the Demand for Emergency Medical Services
2019 (English)In: Proceedings of the 52nd Hawaii International Conference on System Sciences, 2019, University of Hawai'i at Manoa , 2019, p. 1855-1864Conference paper, Published paper (Refereed)
Abstract [en]

Accurate forecast of the demand for emergency medical services (EMS) can help in providing quick and efficient medical treatment and transportation of out-of-hospital patients. The aim of this research was to develop a forecasting model and investigate which factors are relevant to include in such model. The primary data used in this study was information about ambulance calls in three Swedish counties during the years 2013 and 2014. This information was processed, assigned to spatial grid zones and complemented with population and zone characteristics. A Zero-Inflated Poisson (ZIP) regression approach was then used to select significant factors and develop the forecasting model. The model was compared to the forecasting model that is currently incorporated in the EMS information system used by the ambulance dispatchers. The results show that the proposed model performs better than the existing one.

Place, publisher, year, edition, pages
University of Hawai'i at Manoa, 2019
National Category
Transport Systems and Logistics Probability Theory and Statistics Communication Systems
Identifiers
urn:nbn:se:liu:diva-157097 (URN)9780998133126 (ISBN)
Conference
the 52nd Hawaii International Conference on System Sciences, 2019, January 8-11, Grand Wailea, Maui, Hawai'i
Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-05-28Bibliographically approved
2. Optimal Dispatch of Volunteers to Out-of-hospital Cardiac Arrest Patients
Open this publication in new window or tab >>Optimal Dispatch of Volunteers to Out-of-hospital Cardiac Arrest Patients
2019 (English)In: Proceedings of the 52nd Hawaii InternationalConference on System Sciences (HICSS), Hawaii, USA, 8th-11th January 2019, University of Hawai'i at Manoa , 2019, p. 4088-4097Conference paper, Published paper (Refereed)
Abstract [en]

Initiatives with mobile phone dispatched volunteers to out-of-hospital cardiac arrest (OHCA) cases, can be found today in some countries, e.g. Sweden, the Netherlands, Switzerland and Italy. When an OHCA case is reported, an alarm is sent to the registered volunteers’ phones. However, the allocation of which volunteers to send to the automatic external defibrillator (AED) and who to send directly to the patient, is today based on simple rules of thumb. In this paper, we propose a model to optimally select how many and which volunteers to send directly to the patient, and who should pick up and deliver an AED. The results show that the model can help increase the survivability of the patients, compared to simple decision rules.

Place, publisher, year, edition, pages
University of Hawai'i at Manoa, 2019
Keywords
Optimization of and the Use of IT for Healthcare Processes Information Technology in Healthcare Daily emergency, Mixed-integer optimization, Mobile dispatch, SMS life savers, Volunteer management
National Category
Medical Engineering
Identifiers
urn:nbn:se:liu:diva-155670 (URN)9780998133126 (ISBN)
Conference
The 52nd Hawaii InternationalConference on System Sciences (HICSS), Hawaii, USA, 8th-11th January 2019
Available from: 2019-03-25 Created: 2019-03-25 Last updated: 2019-05-28Bibliographically approved

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