Comparison of ambulance diversion policies via simulation

Adrian Ramirez-Nafarrate, A. Baykal Hafizoglu, Esma Gel, John Fowler

Research output: Chapter in Book/Report/Conference proceedingConference contribution

5 Scopus citations


Ambulance diversion (AD) is often used by emergency departments (EDs) to relieve congestion. When an ED is on diversion status, the ED requests ambulances to bypass the facility; therefore ambulance patients are transported to another ED. This paper studies the effect of AD policies on the average waiting time of patients. The AD policies analyzed include (i) a policy that initiates diversion when all the beds are occupied; (ii) a policy obtained by using a Markov Decision Process (MDP) formulation, and (iii) a policy that does not allow diverting at all. The analysis is based on an ED that comprises two treatment areas. The diverted patients are assumed to be transported to a neighboring ED, whose average waiting time is known. The results show significant improvement in the average waiting time spent by patients in the ED with the policy obtained by MDP formulation. In addition, other heuristics are identified to work well compared with not diverting at all.

Original languageEnglish (US)
Title of host publicationProceedings of the 2012 Winter Simulation Conference, WSC 2012
StatePublished - Dec 1 2012
Event2012 Winter Simulation Conference, WSC 2012 - Berlin, Germany
Duration: Dec 9 2012Dec 12 2012

Publication series

NameProceedings - Winter Simulation Conference
ISSN (Print)0891-7736


Other2012 Winter Simulation Conference, WSC 2012

ASJC Scopus subject areas

  • Software
  • Modeling and Simulation
  • Computer Science Applications


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