Optimizing Emergency Department Operations: A Simulation Framework for Managerial Decision-Making.

Emergency departments (EDs) are frequently challenged by fluctuating patient volumes and resource constraints, leading to overcrowding and operational inefficiencies. This study presents a framework that combines design thinking and discrete event simulation (DES) to optimize ED processes and improve patient outcomes. By using both methods in conjunction with the design of experiments, the digital twin evaluates the effects of various resource configurations on key performance indicators, such as length of stay (LOS). The model highlights critical resource bottlenecks and explores alternative scenarios to improve ED performance. A case study demonstrates that targeted adjustments in nurse staffing and bed management significantly improve operational productivity and reduce patient LOS. The proposed approach provides hospital administrators with practical information to optimize resource allocation and streamline ED operations, contributing to better patient experience. This methodology is particularly suited for healthcare systems that face different patient demands and limited resources.