Improving patient access to a public hospital complex using agent simulation

This paper uses agent based simulation to assess the effect of redesigning the points of access to a major public hospital complex in Chile, where nearly 15,000 people will pass through daily. The study is carried out by simulating pedestrian traffic in order to calculate density maps and service levels in hospital access and ramps. The simulation allows us to evaluate the flow of people and assess the layout performance, by identifying high patient flow areas and congested pedestrian traffic zones. By using this approach, it is possible to suggest changes to the original design and to improve pedestrian flow at hospital access points and ramps. The suggested changes reveal that pedestrian indicators could be improved, which in turn would improve the level of satisfaction of patients, relatives, and hospital personnel. A higher satisfaction level would help to reduce stress linked to hospital facilities and crowded spaces.

In recent years, pedestrian traffic management has become an increasingly important matter as population density has increased in major cities. Growing population density requires more and bigger buildings to be built. This affects traffic and the accessibility of public spaces, which were designed for smaller flows of people. This leads to an increase in accidents and higher risks in case of evacuation (Lo, Zhao, Liu, and Coping 2008; Davidich, Geiss, Mayer, Pfaffinger, and Royer 2013).

In developed countries, pedestrian traffic systems are included as an important part of planning and layout design. These systems focus on resource effectiveness, pedestrian safety and the convenience of the building (Løvås 1994).

For this study a simulation model was developed that could predict the flow and behavior of pedestrians for a projected public hospital complex in Chile, where nearly 15,000 persons will arrive daily. This hospital complex design includes an area of 253,793 square meters in three buildings: Exequiel Gonzalez Hospital (EGH) a children’s hospital with 200 beds, Barros Luco Hospital (BLH) an adult’s hospital with 1,000 beds, and an outpatient center, which will be called Barros Luco Hospital Complex.

The main purposes of the study are: to determine pedestrian density maps; saturation areas; the pedestrian flow at entrances and service levels in the access points and ramps of the projected Barros Luco Hospital Complex in Chile; to identify the high patient flow areas and the areas most congested by pedestrian traffic zones. This approach will allow us to suggest changes to improve the original design in terms of pedestrian flow management. The simulation model was built using the agent based modeling library of AnyLogic.

The OECD considers pedestrian transportation to be simpler, more sustainable, and less costly than other forms of transport. Unlike any other transportation mode, a pedestrian’s journey always begins and ends by foot (OECD 2011). Also, pedestrian systems have strategic, tactical, and operational decision levels (Wang, Lo, Liu, and Ma 2015). The increased number of publications related to pedestrian studies in the last decade, especially those related to pedestrian traffic, shows the concern about this subject. With respect to the approaches, simulation is the most widely used for quantitative analysis, followed by mathematical modeling (Alvarez, Mendez, and Martins 2015).

Simulation is one of the recommended troubleshooting tools of complex systems where mathematical modeling is not practical (Medina, Medina, and Gonzalez 2010). There are various sub-categories of simulation, including Monte Carlo Simulation, Dynamic Simulation of Systems, Discrete Event Simulation and Agent-Based Simulation (Wang, Li, Tussey, and Ross 2012; Velasquez, Rodriguez, and Jaen 2011).

The ability to predict how changes in the environment affect pedestrian flow is important for designers of buildings and other facilities. These changes may affect a pedestrian directly by diverting them from the preferred route, and indirectly by affecting other pedestrians (Torrens 2012; Dai, Li, and Liu 2013; Vizzari, Manenti, and Crociani 2013).

AnyLogic agent based simulation model

Simulation model of movement towards the Barros Luco Hospital Complex

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