Performance evaluation of an emergency department in Rio de Janeiro: a hybrid approach using Discrete Events Simulation and Data Envelopment Analysis

Abstract

Abstract The efficiency and quality of the emergency department are paramount to ensure that patients receive immediate and appropriate care. Issues such as lengthy waiting times, critical resource management and allocation, and patient scheduling are linked to increased morbidity and mortality, particularly among the elderly and vulnerable populations. This study aims to assess the performance of an emergency department hospital in Rio de Janeiro based on the analysis of resource utilization and queue performance. The methodology encompassed the development of the emergency macro-process, a preliminary statistical analysis of the collected data, and discrete event simulation under different demand conditions. The study found that the average length of stay in the emergency department was 58.12 minutes, potentially increasing to 104.58 minutes under a 15% demand stress. Improvement scenarios were tested, and their efficiencies were measured using data envelopment analysis in an output-oriented and constant return to scale model. The sensitivity analysis revealed that the proposed performance enhancements could make the hospital more responsive to demand peaks and emergencies, ensuring greater resilience and better resource utilization under adverse conditions.