خداکرم سلیمی فرد

Background: Crisis occurrence in healthcare context, for various reasons, is a phenomenon that happens abundantly. During a crisis occurrence, healthcare system’s first priority is to contribute and provide care services to injured people. But due to severity of crisis and high number of injured people, healthcare responsiveness in qualified and on time response is an important challenge. Resilience conceptual context address this challenge. Aim: Aim to this study is to measure the healthcare responsiveness in crisis, and then accordingly contribute to improve healthcare system performance towards resilience. Methodology: This study applied a new frontier of Operations Research application using concepts of systems resilience. For this purpose, a hybrid simulation optimization approach was used to address this real world challenge. Given that during the crisis, casualties’ first encounter is to emergency department, this department was considered as the studied system. Emergency department current situation and also the critical condition are modeled using discrete-event simulation. Finally, an optimization model using Arena OptQuest was implemented to improve system performance in crisis. Findings: Run of crisis scenarios showed that the system would only be able to respond in the best-case scenario, and in other scenarios the system would collapse, if not considering any special plan. Conclusions: By providing an optimal resource configuration for the studied emergency department, the system can be resilient in simulated crises with inter arrival times of 15.5, 15.2, and 13.8 minutes. However, in simulated crises with time intervals of 12, 8.1 and 6.9 minutes, an optimal configuration can not be proposed and the system will not be responsive.