Real-time patients assignment: A method for improving emergency department flow

Waiting time in emergency department before admission is one of the most important cause of overcrowding of the department. Many difficulties are faced by the decision maker in charge of assigning a bed both to emergency patients and elective inpatients. He has to take into account many constraints and has to find a solution optimizing multiple criteria. He has to deal with the need to minimize the disrupt on the actual planning, to respect the appointment time for inpatient, to reduce the waiting time, .... We propose in this work a mathematical formulation which can be used in a real-time decision support system. Simulation runs on real data from a french hospital of medium-size provides encouraging results for future applications.