![](bg6.png)
In the same manner as the indices used to define
aspects of the real world system when using a Deci-
sion Support System, the attributes of an individual
may not all be of the same type, nor may they all
be static during the course of the simulation. Some
values may be numeric in nature, such as how much
blood a patient has lost, others may require fuzzy
states to more accurately represent naturally occur-
ring, non-numeric conditions such as human concen-
tration.
These factors can be defined as either mutable or
immutable attributes, representing factors that may or
may not change during the course of the simulation
respectively. Mutable attributes may represent such
factors as the level of pain or stress experienced by
an individual at a given moment or the short term
memory of an individual with regard to their expe-
riences within the simulated period. Immutable at-
tributes may represent the level of training a nurse or
doctor has, or the individuals ability to communicate
based on their competence in the local language, these
form the properties of the agent which are unlikely to
change during the course of the simulation.
6 CONCLUSIONS
In the field of healthcare operational management it
has been shown that simulation can be a useful tool.
A number of examples exist in the literature, although
the lack of results from complete implementations
shows that simulation in this area has not reached its
full potential.
A number of requirements for a general and ver-
ifiable simulation are presented. Starting from these
requirements a new model has been created specifi-
cally to work towards creating a tool that can be used
as a basic component of a Decision Support System
which will be easily usable to healthcare managers
to gain insight into the inner workings of current or
planned emergency departments.
A key feature of this project is the use of Agent-
Based Modelling techniques to both take into account
the important social and psychological factors that
come into play during human interactions in high
stress environments such as emergency departments,
but also to aid to reducing the dehumanising appear-
ance of simulation tools from the point of view of
healthcare managers.
The work on this model continues to proceed
based on ongoing investigation and partnership with
a number of hospitals.
ACKNOWLEDGEMENTS
We would like to thank Montse Edo for the detailed
and invaluable assistance provided in describing the
operations of the triage department where she works.
Without the help afforded, this work would not have
been possible.
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