Don't panic - Prepare: Towards crisis-aware models of emergency department operations

The existing models of Emergency Department (ED) operations that are based on the "flow-shop" management logic do not provide adequate decision support in dealing with the ED overcrowding crises. A conceptually different crisis-aware approach to ED modelling and operational decision support is introduced in this paper. It is based on Perrow's theory of "normal accidents" and calls for recognizing the inevitable nature of ED overcrowding crises within current health system setup. Managing the crisis before it happens - a standard approach in crisis management area - should become an integral part of ED operations management. The potential implications of adopting such a crisis-aware perspective for health services research and ED management are outlined.