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With the rising prevalence of patients with autism spectrum disorder (ASD), there has been an increase in the acute presentation of these individuals to the general health care system. Emergency medical services and emergency department personnel commonly address the health care needs of patients with ASD at times of crisis. Unfortunately, there is little education provided to front-line emergency medical technicians, paramedics and emergency nurses on the characteristics of ASD and how these characteristics can create challenges for individuals with ASD and their health care providers in the pre-hospital and emergency department settings. This paper describes the development of educational materials on ASD and the results of training of emergency medical services and emergency department personnel.

Emergency management is vital in implementing sustainable community development, for which community planning must include emergency response solutions to potential natural and manmade hazards. To help maintain such solution repository, we investigate effective fuzzy multi-criteria group decision making (FMCGDM) approaches for the complex problems of evaluating alternative emergency response solutions, where weights for decision makers and criteria are unknown due to problem complexity. We employ interval-valued dual hesitant fuzzy (IVDHF) set to address decision hesitancy more effectively. Based on IVDHF assessments, we develop a deviation maximizing model to compute criteria weights and another compatibility maximizing model to calculate weights for decision makers. Then, two ideal-solution-based FMCGDM approaches are proposed: (i) by introducing a synthesized IVDHF group decision matrix into TOPSIS, we develop an IVDHF-TOPSIS approach for fuzzy group settings; (ii) when emphasizing both maximum group utility and minimum individual regret, we extend VIKOR to develop an IVDHF-VIKOR approach, where the derived decision makers' weights are utilized to obtain group decision matrix and the determined criteria weights are integrated to reflect the relative importance of distances from the compromised ideal solution. Compared with aggregation-operators-based approach, IVDHF-TOPSIS and IVDHF-VIKOR can alleviate information loss and computational complexity. Numerical examples have validated the effectiveness of the proposed approaches.

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T his study is based on the analysis of field data on the revenues and patient flows that we collected on all adult emergency department (ED) visits to a level-1 trauma, tertiary referral center. Our objective was to provide researchers in operations a rich overview of the processes, resources, and metrics of financial and operations performance in the ED. We analyze how patients, physicians, hospitals/physician employer groups, and payers are party to the value created and financial workflow of the ED. A waterfall model for professional services revenue is developed that highlights the impacts of changes in processes, resources, scale, complexity, and mix of patients treated in the ED. We also discuss future implications of new compensation models and potential scenarios that will focus upon controlling costs while maximizing population health and patient satisfaction. These models will necessitate re-engineering of operations in the ED from a strategic perspective. Four major thrusts for selecting the capacity portfolio in the ED operations to align the interests of all the stakeholders are recommended. New avenues for research are also identified.

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