Fifty years of operational research and emergency response

Abstract

Over the past 50 years, a wealth of applications has resulted from researchers turning their attention to operations such as fire suppression, law enforcement and ambulance services. The 1970s might even be argued as the 'golden age' of this particular effort, producing many of the seminal works in fire station location planning, unit assignment and ambulance queuing models. Such efforts naturally continue through to the present, but with a focus shifting away from earlier contexts of established urban emergency service systems. Simultaneously, current evidence from the field suggests that far more work remains. In this paper, we review the operational research (OR) foundation in emergency response so far, highlighting the fact that most of what has been accomplished addresses the well-structured problems of emergency services. This, in turn, offers an explanation for some paradoxical challenges from the field: most of emergency response itself is semistructured, at best. While OR has traditionally focused on the management of an organization, emergency response ultimately requires the management of disorganization, suggesting an important OR growth area for the next 50 years.

Examining the feasibility of using a modelling tool to assess resilience across a health-care system and assist with decisions concerning service reconfiguration

“…Whilst we have not conducted a systematic review of the area, a search of the PUBMED, Web of Science and INFORMS databases using the keywords "resilience" and "health system" or "health service" did not return any relevant articles (although we acknowledge that these search criterion may have excluded other related keywords used by authors). A similar outcome was obtained by back-referencing the recently published review articles in OR and emergency preparedness or disaster planning (Brandeau et al, 2009; Green and Kolesar, 2004;Simpson and Hancock, 2009). The relatively small body of OR work applied to health care in disaster emergencies is generally focused on a specific type of disaster and/or a narrow range of emergency responses affecting a small part of the health care system.…”

“…In recent years there has been a number of relevant editorial, review and position papers on the role of OR in emergency preparedness and emergency response management (Altay and Green, 2006; Brandeau et al, 2009; Green and Kolesar, 2004;Larson, 2004;Larson, 2006;Simpson and Hancock, 2009;Wein et al, 2009;Wright et al, 2006). The problems tackled cover a wide variety of application areas.…”

“…The most common appear to be mathematical programming including heuristics (e.g. Rolland et al, 2010), probability and statistics, and simulation (Green and Kolesar, 2004;Simpson and Hancock, 2009) To the best of our knowledge, there are no OR studies reported in the literature that address the problem of health system resilience. Whilst we have not conducted a systematic review of the area, a search of the PUBMED, Web of Science and INFORMS databases using the keywords "resilience" and "health system" or "health service" did not return any relevant articles (although we acknowledge that these search criterion may have excluded other related keywords used by authors).…”

“…Up until the 1990s, the majority of work in the field focused mainly on 'routine emergencies' within the context of established emergency services such as fire, police and ambulance (Simpson and Hancock, 2009). Research was largely concerned with determining the optimal number, location and allocation of response units within municipal services, as exemplified by the large body of influential work emanating from the New York City -RAND Institute (Green and Kolesar, 2004;Larson, 2002).…”

“…increased waiting lists for elective care). Nor does our approach allow for disruptions to health systems with existing waiting lists (we use a simplifying assumption that, 16 immediately prior to a disruption, demand for services is met), and we note that the long terms effects on such services could be substantial even if the immediate emergency response is adequate.Both the mathematical model and accompanying prototype software tool differ substantially from other published modelling work in the field of emergency preparedness, not least because we addressed issues of strategic decisions in health system planning as opposed to operational issues arising from disruptions (Green and Kolesar, 2004;Simpson and Hancock, 2009) In this paper, we have given a detailed account of an OR project that investigated the feasibility of developing a modelling tool that can be used to provide estimates of unmet demand for services under conditions of disruption while allowing for different levels of system response. The intended usage of such tool would be to provide emergency planning personnel with a systematic means of informing improvements to NHS resilience and in assessing the potential impact on resilience of any proposed reconfiguration of services.…”