Search results for: patient modeling.

Authors: Azam Marjani, Saeed Shirazian

Abstract:

This work deals with modeling and simulation of SO2 removal in a ceramic membrane by means of FEM. A mass transfer model was developed to predict the performance of SO2 absorption in a chemical solvent. The model was based on solving conservation equations for gas component in the membrane. Computational fluid dynamics (CFD) of mass and momentum were used to solve the model equations. The simulations aimed to obtain the distribution of gas concentration in the absorption process. The effect of the operating parameters on the efficiency of the ceramic membrane was evaluated. The modeling findings showed that the gas phase velocity has significant effect on the removal of gas whereas the liquid phase does not affect the SO2 removal significantly. It is also indicated that the main mass transfer resistance is placed in the membrane and gas phase because of high tortuosity of the ceramic membrane.

Keywords: Gas separation, finite element, ceramic, sulphur dioxide, simulation.

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Authors: A. Zanj, F. He

Abstract:

In the current paper, a domain independent conduction model compatible for multi-physical system dynamic investigations is suggested. By means of a port-based approach, a classical nonlinear conduction model containing physical states is first represented. A compatible discrete configuration of the thermal domain in line with the elastic domain is then generated through the enhancement of the configuration of the conventional thermal element. The presented simulation results of a sample structure indicate that the suggested conductive model can cover a wide range of dynamic behavior of the thermal domain.

Keywords: Multi-physical domain, conduction model, port-based modeling, dynamic interaction, physical modeling.

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Authors: H. Yazdani, K. Ghorbanian

Abstract:

This paper deals with modeling and simulation of the plasma actuator with OpenFOAM. Plasma actuator is one of the newest devices in flow control techniques which can delay separation by inducing external momentum to the boundary layer of the flow. The effects of the plasma actuators on the external flow are incorporated into Navier-Stokes computations as a body force vector which is obtained as a product of the net charge density and the electric field. In order to compute this body force vector, the model solves two equations: One for the electric field due to the applied AC voltage at the electrodes and the other for the charge density representing the ionized air. The simulation result is compared to the experimental and typical values which confirms the validity of the modeling.

Keywords: Active flow control, flow field, OpenFOAM, plasma actuator.

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Authors: A.R. Aswatha, T. Basavaraju, S. Sandeep Kumar

Abstract:

Timing driven physical design, synthesis, and optimization tools need efficient closed-form delay models for estimating the delay associated with each net in an integrated circuit (IC) design. The total number of nets in a modern IC design has increased dramatically and exceeded millions. Therefore efficient modeling of interconnection is needed for high speed IC-s. This paper presents closed–form expressions for RC and RLC interconnection trees in current mode signaling, which can be implemented in VLSI design tool. These analytical model expressions can be used for accurate calculation of delay after the design clock tree has been laid out and the design is fully routed. Evaluation of these analytical models is several orders of magnitude faster than simulation using SPICE.

Keywords: IC design, RC/RLC Interconnection, VLSI Systems.

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Authors: B. Tomczyk, R. Mania

Abstract:

Thin linear-elastic cylindrical circular shells having a micro-periodic structure along two directions tangent to the shell midsurface (biperiodic shells) are object of considerations. The aim of this paper is twofold. First, we formulate an averaged nonasymptotic model for the analysis of parametric vibrations or dynamical stability of periodic shells under consideration, which has constant coefficients and takes into account the effect of a cell size on the overall shell behavior (a length-scale effect). This model is derived employing the tolerance modeling procedure. Second we apply the obtained model to derivation of frequency equation being a starting point in the analysis of parametric vibrations. The effect of the microstructure length oh this frequency equation is discussed.

Keywords: Micro-periodic shells, mathematical modeling, length-scale effect, parametric vibrations

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Authors: M.A. Kamely, S.M. Kamil, C.W. Chong

Abstract:

A mathematical model of the surface roughness has been developed by using response surface methodology (RSM) in grinding of AISI D2 cold work tool steels. Analysis of variance (ANOVA) was used to check the validity of the model. Low and high value for work speed and feed rate are decided from design of experiment. The influences of all machining parameters on surface roughness have been analyzed based on the developed mathematical model. The developed prediction equation shows that both the feed rate and work speed are the most important factor that influences the surface roughness. The surface roughness was found to be the lowers with the used of low feed rate and low work speed. Accuracy of the best model was proved with the testing data.

Keywords: Mathematical Modeling, Response surfacemethodology, Surface roughness, Cylindrical Grinding.

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Authors: Mohammad Ahmed Rehmatullah

Abstract:

The aim of this paper is to discuss a low-cost methodology that can predict traffic flow conflicts and quantitatively rank crash expectancies (based on relative probability) for various traffic facilities. This paper focuses on the application of statistical distributions to model traffic flow and Monte Carlo techniques to simulate traffic and discusses how to create a tool in order to predict the possibility of a traffic crash. A low-cost data collection methodology has been discussed for the heterogeneous traffic flow that exists and a GIS platform has been proposed to thematically represent traffic flow from simulations and the probability of a crash. Furthermore, discussions have been made to reflect the dynamism of the model in reference to its adaptability, adequacy, economy, and efficiency to ensure adoption.

Keywords: Heterogeneous traffic data collection, Monte CarloSimulation, Traffic Flow Modeling, GIS.

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Authors: Marinka Baghdasaryan, Tigran Mnoyan

Abstract:

The pertinence of modeling the moment of resistance generated by the ore-grinding mill is substantiated. Based on the ranking of technological indices obtained in the result of the survey among the specialists of several beneficiating plants, the factors determining the level of the moment of resistance generated by the mill are revealed. A priori diagram of the ranks is obtained in which the factors are arranged in the descending order of the impact degree on the level of the moment. The obtained model of the moment of resistance shows the technological character of the operation modes of the ore-grinding mill and can be used for improving the operation modes of the system motor-mill and preventing the abnormal mode of the drive synchronous motor.

Keywords: Model, abnormal mode, mill, correlation, moment of resistance, rotational speed.

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Authors: Abdulbaset Saad, Adel Younis, Zuomin Dong

Abstract:

For design optimization with high-dimensional expensive problems, an effective and efficient optimization methodology is desired. This work proposes a series of modification to the Differential Evolution (DE) algorithm for solving computation Intensive Black-Box Problems. The proposed methodology is called Radial Basis Meta-Model Algorithm Assisted Differential Evolutionary (RBF-DE), which is a global optimization algorithm based on the meta-modeling techniques. A meta-modeling assisted DE is proposed to solve computationally expensive optimization problems. The Radial Basis Function (RBF) model is used as a surrogate model to approximate the expensive objective function, while DE employs a mechanism to dynamically select the best performing combination of parameters such as differential rate, cross over probability, and population size. The proposed algorithm is tested on benchmark functions and real life practical applications and problems. The test results demonstrate that the proposed algorithm is promising and performs well compared to other optimization algorithms. The proposed algorithm is capable of converging to acceptable and good solutions in terms of accuracy, number of evaluations, and time needed to converge.

Keywords: Differential evolution, engineering design, expensive computations, meta-modeling, radial basis function, optimization.

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Authors: Husam El-Asfour, Fateh Adhnouss, Kenneth McIsaac, AbdulMutalib Wahaishi, Raafat Aburukba, Idris El-Feghia

Abstract:

Although intelligence is commonly referred to as the observable behavior in various fields and domains, it must also be shown how it develops by exhibiting multiple forms and without observing the inherent behavior. There have been several official and informal definitions of intelligence in various areas; however, no scientific agreement on a definition has been agreed upon. There must be a single definition, structure, and precise modeling for articulating how intelligence is perceived by people and machines in order to comprehend intelligence. Another key challenge is defining the different environment types based on the integral elements (agents) and their possible interactions. On the basis of conceptualization, this paper proposes a formal model for defining and developing intelligence. Forms of intelligence are derived from an ontological view, and thus intelligence is defined, described, and modeled based on the various types of environments.

Keywords: Intelligence, forms, transformation, conceptualization, ontological view.

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Authors: Gamal Abd El-Nasser A. Said, El-Sayed M. El-Horbaty

Abstract:

Container handling problems at container terminals are NP-hard problems. This paper presents an approach using discrete-event simulation modeling to optimize solution for storage space allocation problem, taking into account all various interrelated container terminal handling activities. The proposed approach is applied on a real case study data of container terminal at Alexandria port. The computational results show the effectiveness of the proposed model for optimization of storage space allocation in container terminal where 54% reduction in containers handling time in port is achieved.

Keywords: Container terminal, discrete-event simulation, optimization, storage space allocation.

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Authors: Dawit Mengistu, Lars Lundberg, Paul Davidsson

Abstract:

A major requirement for Grid application developers is ensuring performance and scalability of their applications. Predicting the performance of an application demands understanding its specific features. This paper discusses performance modeling and prediction of multi-agent based simulation (MABS) applications on the Grid. An experiment conducted using a synthetic MABS workload explains the key features to be included in the performance model. The results obtained from the experiment show that the prediction model developed for the synthetic workload can be used as a guideline to understand to estimate the performance characteristics of real world simulation applications.

Keywords: Grid computing, Performance modeling, Performance prediction, Multi-agent simulation.

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Authors: M. Sedighizadeh, A. Rezazadeh

Abstract:

Based on the component approach, three kinds of dynamic load models, including a single –motor model, a two-motor model and composite load model have been developed for the stability studies of Khuzestan power system. The study results are presented in this paper. Voltage instability is a dynamic phenomenon and therefore requires dynamic representation of the power system components. Industrial loads contain a large fraction of induction machines. Several models of different complexity are available for the description investigations. This study evaluates the dynamic performances of several dynamic load models in combination with the dynamics of a load changing transformer. Case study is steel industrial substation in Khuzestan power systems.

Keywords: Dynamic load, modeling, Voltage Stability.

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Authors: Gabriela Lindemann, Danilo Schmidt, Thomas Schrader, Dietmar Keune

Abstract:

The amount and heterogeneity of data in biomedical research, notably in interdisciplinary fields, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charité - University Hospital Berlin has established together with the German Research Foundation (DFG) a new information service centre for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). Beside a collaborative aspect to create new research groups every single partner or institution of this science information centre making his own data available is allowed to search the whole data pool of the various involved centres. A core task is the implementation of a non-restricting open data structure for the various different data sources. We decided to use a modern RDF model and in a first phase transformed original data coming from the web-based Electronic Patient Record database TBase©.

Keywords: Medical databases, Resource Description Framework (RDF), metadata repository.

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Authors: A. Soltani, M. Karimi Demneh

Abstract:

In this paper, modeling of an acoustic enclosed vehicle cabin has been carried out by using boundary element method. Also, the second purpose of this study is analyzing of linear wave equation in an acoustic field. The resultants of this modeling consist of natural frequencies that have been compared with resultants derived from finite element method. By using numerical method (boundary element method) and after solution of wave equation inside an acoustic enclosed cabin, this method has been progressed to simulate noise inside a simple vehicle cabin.

Keywords: Boundary element method, natural frequency, noise, vehicle cabin.

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Authors: Sang Yeong Choi, Woo Sung Park

Abstract:

This paper presents the architecture design of the robot operability assessment simulation testbed (called "ROAST") for the resolution of robot operability problems occurred during interactions between human operators and robots. The basic idea of the ROAST architecture design is to enable the easy composition of legacy or new simulation models according to its purpose. ROAST architecture is based on IEEE1516 High Level Architecture (HLA) of defense modeling and simulation. The ROAST architecture is expected to provide the foundation framework for the easy construction of a simulation testbed to order to assess the robot operability during the robotic system design. Some of ROAST implementations and its usefulness are demonstrated through a simple illustrative example.

Keywords: Robotic system, modeling and simulation, Simulation architecture.

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Authors: Ivana Mokrá

Abstract:

The article deals with modelling of the fire pragmatism in the area of military management and its experimental verification. Potential approaches are based on the synergy of mathematical and theoretical ideas, operational and tactical requirements and the military decision-making process. This issue has taken on importance in recent times, particularly with the increasing trend of digitized battlefield, the development of C4ISR systems and intention to streamline the command and control process at the lowest levels of command. From fundamental and philosophical point of view, these new approaches seek to significantly upgrade and enhance the decision-making process of the tactical commanders.

Keywords: Military management, decision-making process, strike modeling, experimental evaluation, pragmatism, tactical strike modeling

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Authors: Toshihiko Matsuka, James E. Corter

Abstract:

Most neural network (NN) models of human category learning use a gradient-based learning method, which assumes that locally-optimal changes are made to model parameters on each learning trial. This method tends to under predict variability in individual-level cognitive processes. In addition many recent models of human category learning have been criticized for not being able to replicate rapid changes in categorization accuracy and attention processes observed in empirical studies. In this paper we introduce stochastic learning algorithms for NN models of human category learning and show that use of the algorithms can result in (a) rapid changes in accuracy and attention allocation, and (b) different learning trajectories and more realistic variability at the individual-level.

Keywords: category learning, cognitive modeling, radial basis function, stochastic optimization.

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Authors: Sezen Yildirim, Tahir Çetin Akinci, Serhat Seker, Nazmi Ekren

Abstract:

Ferroresonance is an electrical phenomenon in nonlinear character, which frequently occurs in power system due to transmission line faults and single or more-phase switching on the lines as well as usage of the saturable transformers. In this study, the ferroresonance phenomena are investigated under the modeling of the West Anatolian Electric Power Network of 380 kV in Turkey. The ferroresonance event is observed as a result of removing the loads at the end of the lines. In this sense, two different cases are considered. At first, the switching is applied at 2nd second and the ferroresonance affects are observed between 2nd and 4th seconds in the voltage variations of the phase-R. Hence the ferroresonance and nonferroresonance parts of the overall data are compared with each others using the Fourier transform techniques to show the ferroresonance affects.

Keywords: Ferroresonance, West Anatolian Electric Power System, Power System Modeling, Switching, Spectral Analysis.

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Authors: Ya-Fen Lee, Yun-Yao Chi

Abstract:

The study aims to explore the relationship between risk perception of rockfall and revisit intention using a Structural Equation Modeling (SEM) analysis. A total of 573 valid questionnaires are collected from travelers to Taroko National Park, Taiwan. The findings show the majority of travelers have the medium perception of rockfall risk, and are willing to revisit the Taroko National Park. The revisit intention to Taroko National Park is influenced by hazardous preferences, willingness-to-pay, obstruction and attraction. The risk perception has an indirect effect on revisit intention through influencing willingness-to-pay. The study results can be a reference for mitigation the rockfall disaster.

Keywords: Risk perception, rockfall, revisit intention, structural equation modeling.

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Authors: R. Prakash, B. Meenakshipriya, R. Kumaravelan

Abstract:

This paper presents modeling and simulation of Grid Connected Photovoltaic (PV) system by using improved mathematical model. The model is used to study different parameter variations and effects on the PV array including operating temperature and solar irradiation level. In this paper stepped P&O algorithm is proposed for MPPT control. This algorithm will identify the suitable duty ratio in which the DC-DC converter should be operated to maximize the power output. Photo voltaic array with proposed stepped P&O-MPPT controller can operate in the maximum power point for the whole range of solar data (irradiance and temperature).

Keywords: Photovoltaic (PV), Maximum Power Point Tracking (MPPT), Boost converter, Stepped Perturb & Observe method (Stepped P&O).

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Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

Abstract:

The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: Caregiving, design basics, family integration, hospital ward, sustainability.

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Authors: Shahabeddin Sotudian, M. H. Fazel Zarandi, I. B. Turksen

Abstract:

Hepatitis is one of the most common and dangerous diseases that affects humankind, and exposes millions of people to serious health risks every year. Diagnosis of Hepatitis has always been a challenge for physicians. This paper presents an effective method for diagnosis of hepatitis based on interval Type-II fuzzy. This proposed system includes three steps: pre-processing (feature selection), Type-I and Type-II fuzzy classification, and system evaluation. KNN-FD feature selection is used as the preprocessing step in order to exclude irrelevant features and to improve classification performance and efficiency in generating the classification model. In the fuzzy classification step, an “indirect approach” is used for fuzzy system modeling by implementing the exponential compactness and separation index for determining the number of rules in the fuzzy clustering approach. Therefore, we first proposed a Type-I fuzzy system that had an accuracy of approximately 90.9%. In the proposed system, the process of diagnosis faces vagueness and uncertainty in the final decision. Thus, the imprecise knowledge was managed by using interval Type-II fuzzy logic. The results that were obtained show that interval Type-II fuzzy has the ability to diagnose hepatitis with an average accuracy of 93.94%. The classification accuracy obtained is the highest one reached thus far. The aforementioned rate of accuracy demonstrates that the Type-II fuzzy system has a better performance in comparison to Type-I and indicates a higher capability of Type-II fuzzy system for modeling uncertainty.

Keywords: Hepatitis disease, medical diagnosis, type-I fuzzy logic, type-II fuzzy logic, feature selection.

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Authors: Dae-Hee Son, Sang-Hee Kang, Soon-Ryul Nam

Abstract:

In this paper, we develop a dynamic modeling of wind farms in the Jeju power system. The dynamic model of wind farms is developed to study their dynamic effects on the Jeju power system. PSS/E is used to develop the dynamic model of a wind farm composed of 1.5-MW doubly fed induction generators. The output of a wind farm is regulated based on pitch angle control, in which the two controllable parameters are speed and power references. The simulation results confirm that the pitch angle is successfully controlled, regardless of the variation in wind speed and output regulation.

Keywords: Dynamic model, Jeju power system, pitch angle control, PSS/E, wind farm.

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Authors: Siamak Najarian, Meysam Esmaeili, Mohsen Towliat Kashani

Abstract:

In this article, we propose a new surgical device for circumferentially excision of high anal fistulas in a minimally invasive manner. The new apparatus works on the basis of axially rotating and moving a tubular blade along a fistulous tract straightened using a rigid straight guidewire. As the blade moves along the tract, its sharp circular cutting edge circumferentially separates approximately 2.25 mm thickness of tract encircling the rigid guidewire. We used the new set to excise two anal fistulas in a 62-year-old male patient, an extrasphincteric type and a long tract with no internal opening. With regard to the results of this test, the new device can be considered as a sphincter preserving mechanism for treatment of high anal fistulas. Consequently, a major reduction in the risk of fecal incontinence, recurrence rate, convalescence period and patient morbidity may be achieved using the new device for treatment of fistula-in-ano.

Keywords: Fecal Incontinence, Fistulectomy, High Anal Fistula, Minimally Invasive.

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Authors: S. Bennoud, M. Zergoug

Abstract:

The numerical simulation of electromagnetic interactions is still a challenging problem, especially in problems that result in fully three dimensional mathematical models.

The goal of this work is to use mathematical modeling to characterize the reliability and capacity of eddy current technique to detect and characterize defects embedded in aeronautical in-service pieces.

The finite element method is used for describing the eddy current technique in a mathematical model by the prediction of the eddy current interaction with defects. However, this model is an approximation of the full Maxwell equations.

In this study, the analysis of the problem is based on a three dimensional finite element model that computes directly the electromagnetic field distortions due to defects.

Keywords: Eddy current, Finite element method, Non destructive testing, Numerical simulations.

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Authors: Zeeshan Hamid, Asher Ramish

Abstract:

The purpose of this paper is to focus on security and safety issues facing by pharmaceutical industry globally when counterfeit drugs are in question. Hence, there is an intense need to secure and authenticate pharmaceutical products in the emerging counterfeit product market. This paper will elaborate the application of radio frequency identification (RFID) in pharmaceutical industry and to identify its key benefits for patient’s care. The benefits are: help to co-ordinate the stream of supplies, accuracy in chains of supplies, maintaining trustworthy information, to manage the operations in appropriate and timely manners and finally deliver the genuine drug to patient. It is discussed that how RFID supported supply chain information sharing (SCIS) helps to combat against counterfeit drugs. And a solution how to tag pharmaceutical products; since, some products prevent RFID implementation in this industry. In this paper, a proposed model for pharma industry distribution suggested to combat against the counterfeit drugs when they are in supply chain.

Keywords: Supply chain, RFID, pharmaceutical industry, counterfeit drugs, patients care.

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Authors: F. C. Calnegru

Abstract:

This article presents a computationally tractable probabilistic model for the relation between the complex wavelet coefficients of two images of the same scene. The two images are acquisitioned at distinct moments of times, or from distinct viewpoints, or by distinct sensors. By means of the introduced probabilistic model, we argue that the similarity between the two images is controlled not by the values of the wavelet coefficients, which can be altered by many factors, but by the nature of the wavelet coefficients, that we model with the help of hidden state variables. We integrate this probabilistic framework in the construction of a new image registration algorithm. This algorithm has sub-pixel accuracy and is robust to noise and to other variations like local illumination changes. We present the performance of our algorithm on various image types.

Keywords: Complex wavelet transform, image registration, modeling using hidden state variables, probabilistic similaritymeasure.

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Authors: Anders Troedsson

Abstract:

For us humans, risk and insecurity are intimately linked to vulnerabilities - where there is vulnerability, there is potentially risk and insecurity. Reducing vulnerability through compensatory measures means decreasing the likelihood of a certain external event be qualified as a risk/threat/assault, and thus also means increasing the individual’s sense of security. The paper suggests that a meaningful way to approach the study of risk/ insecurity is to organize thinking about the vulnerabilities that external phenomena evoke in humans as perceived by them. Such phenomena are, through a set of given vulnerabilities, potentially translated into perceptions of "insecurity." An ontological discussion about salient timespace characteristics of external phenomena as perceived by humans, including such which potentially can be qualified as risk/threat/assault, leads to the positing of two dimensions which are central for describing what in the paper is called the essence of risk/threat/assault. As is argued, such modeling helps analysis steer free of the subjective factor which is intimately connected to human perception and which mediates between phenomena “out there” potentially identified as risk/threat/assault, and their translation into an experience of security or insecurity. A proposed set of universally given vulnerabilities are scrutinized with the help of the two dimensions, resulting in a modeling effort featuring four realms of vulnerabilities which together represent a dynamic whole. This model in turn informs modeling on human security.

Keywords: Human vulnerabilities, human security, inert-immediate, material-immaterial, timespace.

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Authors: G. Feletti, D. Tedesco, P. Trucco

Abstract:

The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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