Resource allocation p olicies for minimizing mortality in mass casualty events
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Resource Allocation P olicies for Minimizing Mortality in Mass Casualty Events ‏. Dr. Izack Cohen izik68@Technion.ac.il Prof . Avishai Mandelbaum, Noa Zychlinski MSc. The Faculty of Industrial Engineering and Management The Technion – Israel institution of Technology.

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Resource allocation p olicies for minimizing mortality in mass casualty events

Resource Allocation Policies for Minimizing Mortality inMass Casualty Events‏

Dr. Izack Cohen

izik68@Technion.ac.il

Prof. AvishaiMandelbaum, Noa Zychlinski MSc.

The Faculty of Industrial Engineering and Management

The Technion – Israel institution of Technology


Resource allocation p olicies for minimizing mortality in mass casualty events

Indian Ocean, 2004

NYC, 2001

Madrid, 2004

Japan, 2011

Turkey, 2011

Rio De Janeiro, 2011

Argentina, 1994

London, 2005

Oklahoma City, 1995


Resource allocation p olicies for minimizing mortality in mass casualty events

The Main Results

  • A general, fluid-model based approach, for modeling MCEs.

  • An MCE classification scheme ,wherein a resource allocation policy is suggested for each class.

  • A real-time management approach.


Resource allocation p olicies for minimizing mortality in mass casualty events

Flow of Casualties through an ED during an MCE


Casualties flow in a two station n etwork
Casualties Flow in a Two-Station Network

Mortality

Mortality

To admission and ICU

To immediate operation

Arriving Immediates

(1)

Shock Rooms

(2)

Operation Rooms

To admission and ICU


Resource allocation p olicies for minimizing mortality in mass casualty events

Optimization Problem

Casualties at Station

Mortality Rate

Minimizing Mortality

Treatment Rate

Arrival Rate

Casualties at Station

Surgeons at Station

Balance Equation for Station 1

Change in Casualties

Resource Constraint

Balance Equation for Station 2



Resource allocation p olicies for minimizing mortality in mass casualty events

Policies Application

(b)

(a)

A dynamic allocation of surgeons to two treatment stations, life-saving followed by operating, so as to minimize mortality during an MCE. (a) Represents an event that took place far from the hospital, hence the arrival waves are 60 minutes apart and (b) represents an event at closer proximity where the arrival waves are 15 minutes apart.


Resource allocation p olicies for minimizing mortality in mass casualty events

MCE Real-Time Management

Optimal resource allocation solutions for different time points 0, 60, 120, 180


Resource allocation p olicies for minimizing mortality in mass casualty events

Summary

  • Traditional MCE models are based on simulation experiments.

  • We used fluid models to formulate the problem and then gained structural results.

  • The suggested optimal allocation policies can be easily applied to prepare an emergency plan for reference scenarios.

  • A developed rolling horizon approach allows for real-time management of MCEs.


Resource allocation p olicies for minimizing mortality in mass casualty events

Acknowledgements

  • Prof. Avishai Mandelbaum, Mrs. Noa Zychlinski – co-authors

  • Dr. Michalson Moshe, Medical Director of Trauma teaching center,

  • Rambam Hospital

  • Dr. Israelit Shlomi, Chief of ED, Rambam Hospital