Data-driven queueing modelling: a simulation case study of emergency department crowding

OBJECTIVES: Emergency department crowding refers to a complex state of congestion associated with a set of performance indicators such as occupation levels, waiting times and specific scores. Among current methods to model it, an objective gap exists between forecasting machine learning methods, focusing on prediction precision and queueing and simulation methods, focusing on capturing correctly the effect of decision variables for evaluation and optimisation purposes. The objective of the present analysis is to implement and numerically validate a novel data-driven queueing methodology that can bridge this gap and to show its applicability in a simulation case study. METHODS: A statistical modelling of the queueing processes, particularly patient departure rates and probabilities, is developed to cross the gap defined above. Using the data from a major emergency department of eastern France, the resultant data-driven queueing network model is validated and applied through a synchronous simulation algorithm. RESULTS: The model obtained considers the complex effects of patient arrivals and doctor and nurse allocations while offering an unbiased and accurate measure of long-term crowding. Its application with the case study quantifies the impact of the opening of new Unscheduled Care Services on emergency department crowding. DISCUSSION: The new data-driven queueing methodology is able to model and quantify complex crowding effects at a detailed level in an emergency department. CONCLUSIONS: This study shows an alternative approach successfully bridging the modelling gap by establishing a model that can effectively predict system crowding dynamics under the influence of multiple key variables.