Multi-criteria approach using simulation-based balanced scorecard for supporting decisions in health-care facilities: an emergency department case study

Health research is a priority in every economy, and this research–set in the context of building a more sustainable and efficient health-care system–examines how operations management practices can be translated to clinical applications. Health-care systems in general (and emergency departments (EDs) in particular) around the world are facing enormous challenges in meeting the increasingly conflicting objectives of providing wide accessibility and delivering high-quality services efficiently and promptly. The framework proposed in this study integrates simulation modelling, the Balanced Scorecard, and multi-criteria decision analysis with the aim of providing a decision support system for health-care managers. Using the Analytic Hierarchy Process, simulation results are aggregated to achieve defined strategic as well as tactical and operational objectives. Communicating the significance of investigated strategies can encourage managers to implement the framework’s recommendations in the ED within the partner hospital.