Béatrix Besombes

Modelling and simulation of emergency services with ARIS and Arena. Case study: the emergency department of Saint Joseph and Saint Luc Hospital

Overlong waiting time in emergency services is an important matter which has negative influence on healthcare quality. This problem can be resolved by improving emergency services using modelling and discrete event simulation of system process. In this article, a simulation model is designed to represent the patient visit process by using, respectively, IDS Scheer ARIS™ and Rockwell Arena™. This simulation model can help us to identify process bottlenecks, and adjust resources allocation or staff dimensioning without disturbing the actual system. For the purpose of reducing waiting time in emergency departments (ED), doctors efficiency improvement and quick pass process are proposed and experimented as two new solutions. In addition to simulation results, we summarise some advantages and shortcomings observed during our development work for future use of ARIS and Arena. This work was based on the ED at Saint Joseph and Saint Luc Hospital in Lyon, France.

Constructing a typology for networks of firms

Companies are now economically bound to collaborate with other enterprises, forming horizontal networks that are generally goal-based and are of a limited duration. This article specifically addresses networks of industrial small and medium enterprises (SMEs). Thanks to a five-years study, some of the main characteristics of such networks will be clarified. One upshot from the experiment was that such networks are rarely guided by formal and deliberate strategies, and that their evolutions and mutations cannot be forecast with the usual strategic planning tools. This paper presents a formal framework to analysis and design the trajectories of networks of firms, with the aim of facilitating the strategic guidance of the network. First, approaches dealing with strategic evolution are presented. Next, organizational trajectories are examined, based on the relative situation of activities and competencies between the companies inside the network. Then, a typology of SMEs networks is given and illustrated by industrial cases. Finally, a formal frame based on the typology and on the degree of achievement of the network (as expressed by a six-levels Maslows pyramid) is presented, which allows location and guidance of SMEs networks according to their needs. As an illustration a real network trajectory is also given.

A reliability diagnosis to support servitization decision-making process

– Servitization of manufacturing is characterized by very complex decision processes within strongly unstable and uncertain decision contexts. Decision-makers are face situations of lack of internal and external information. The purpose of this paper is to develop a decision aid approach to support the management of servitization decision-making processes. , – The scientific orientation of this research consists in working at improving the efficiency of the servitization decision-making process, by identifying factors of non-reliability, in order to propose remediation actions for the whole process. Improving the final decisions taken by the managers is considered as a consequence of the improvement of the decision-making process reliability. The method, based on modeling and evaluation, requires the specification of a decision process model for servitization, used as a basis to assess decision process reliability and diagnose the enterprise’s servitization decision system. Improving the final decisions made by the managers is considered as a consequence of the improvement of the decision-making process reliability. , – Key added values: first, to formalize a servitization decision-making reference model; second, to specify a reliability assessment applied to the decision system; and third, to define a decision process reliability diagnosis procedure for servitization, illustrated in a case study. , – A direct perspective is to complete the focus on procedural reliability, by taking into consideration the subjective rationality of decision-makers in the reliability assessment procedure. Additionally, this reliability assessment method and diagnosis could become the basis of a larger risk management approach for servitization. , – The diagnosis procedure proposed in the paper is dedicated to generating practical results for enterprise decision-makers, consisting in recommendations for decision process improvements, in the context of servitization. The approach is illustrated through an industrial SME case study. The practical implications are highly contextualized. , – The key originality of this research is to tackle servitization complexity with a decision system modeling and diagnosis orientation, including the formalization of the notion of “decision process reliability,” and the specification and implementation of a quantitative assessment procedure.

A Sizing Tool for Allocation Planning of Hospital Bed Resources

This paper focuses on bed resources allocation in hospital taking into account hospitalization demands, bed capacity, and “Tarification a l’Activite” (T2A) incomes. The data used in this research work combine the elective patient flow and the acute patient flow from emergency department. A mathematical model based on a dynamic dispatching approach is developed and experimented respectively with two mathematical optimization solvers, Lingo and Cplex. Our objective is to maximize the incomes based on T2A and to minimize the cost to use supplementary beds. As a result of this model, the bed allocation planning calculated from the best objective value is presented.

Toward a Decision Support Tool for Emergency Networks in France

The complexity of the Emergency Supply Chains makes its management very difficult. Hence, we present in this article a comprehensive view of the French emergency supply chain (ESC), we propose an ad hoc relationship model between actors, and a GRAI grid-based model to initiate a new approach for controlling the ESC deficiencies, especially related to decision making. Throughout the article, we discuss the interest of the use of enterprise modelling to model the ESC. We discuss too, the characterization of the different issues related to the steering of the ESC. A literature review based on the GRAI grid model is proposed and discussed too. The GRAI method is used here because it presents the advantage of using the theory of complex systems, and it provides a dynamic model of an organization by focusing on decision-making and decisions communication.

Réorganisation d'un service d'urgences et aide au pilotage des flux de patients : Apport de la modélisation d'entreprise et de la simulation de flux

L’objet de cet article est de montrer l’intérêt du couplage des méthodes de modélisation d’entreprise et de simulation de flux, pour la réorganisation et le pilotage des processus de prise en charge des patients aux urgences. Nous présentons au travers de l’article, la démarche suivie pour la réorganisation, et les résultats obtenus lors du déploiement de la démarche. La finalité du travail est de tester et de valider différentes stratégies de pilotage, pour minimiser les durées de séjour et les temps d’attente des patients aux urgences. Nous détaillons cette démarche à partir d’une expérience d’accompagnement du service d’urgences du Centre Hospitalier Universitaire de Saint Etienne.