Application of behavioral simulation models to patient flows in Emergency Medical Teams (EMTs)

The effectiveness of care provided by Emergency Medical Teams (EMTs), which often operates in resource-scarce environments with limited personnel and infrastructure, is closely linked to coordinated patient flow management. Although widely used in conventional hospital settings, structured patient flow optimization seems to be rarely promoted in these contexts. To support this quantitative analysis, this paper explores the use of a behavioural computer simulation to model patient flow through an EMT facility and evaluate main leading strategies which can potentially improve operational rapidity while solving critical interactions among patients. An agent-based behavioural simulation model, capable of representing individual movements and interactions between patients, staff members, and physical layout of the health care facility, is provided, characterizing each agent with specific attributes and constraints related to the emergency scenario. Then, behavioural key performance indicators (KPIs) are defined to analyse simulation outputs and assess the effectiveness of EMTs organization under several patient-related and operational scenarios, in terms of operational rapidity and (over-)crowding. An application to a typological field hospital under relevant working conditions demonstrates the methodology capabilities, quantitatively tracing the effective impact of consolidated strategy, dedicate facility accesses, optimization in supporting staff number and implementation of internal wayfinding systems). Behavioural simulations can be incorporated in WHO EMT decision-support frameworks in field hospitals, supporting informed re-design and adaptation of EMT management and layouts in different deployment contexts, and training and preparedness thanks to better understanding of patient flow dynamics.