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International audience; In the context of low energy buildings we study the impact of the incoming radiation through a window (sun patch) on the heating and cooling demand. Existing studies have shown that not considering the sun patch and fast climatic variations (Figure 4, Global radiation) can lead to important differences in energy power evaluation [1, 2, 3]. In this paper we present a 3D envelope model taking into account the minute-wise sun patch evolution. Simulation results are analysed for a low energy cell. A numerical model has been developed in order to simulate the transient thermal behaviour, with a refined spatial (3D) and temporal (down to one minute time step) discretization of the single room. For each node of the grid, the energy conservation equations are developed. They traduce balance between short-wave and long-wave irradiations, convection, air enthalpy and three-dimensional heat conduction. The particularities of the program are that it projects the sun patch on the inner walls, the conduction is treated in three dimensions and climatic minute-wise variations are taken into account. As main results, the surface temperature evolution, the air temperature evolution and the heating or cooling power necessary to maintain an inner air set-point temperature are calculated at each time-step. Heating or cooling power is compared to the power calculated with no sun patch incorporation (solar loads only on the floor). Conclusions are made on the importance of the integration of the sun patch and its impact on the observed results.

International audience; This paper focuses on bed resources allocation in hospital taking into account hospitalization demands, bed capacity, and “Tarification à l’Activité” (T2A) incomes. The data used in this research work combine the elective patient flow and the acute patient flow from emergency department. A mathematical model based on a dynamic dispatching approach is developed and experimented respectively with two mathematical optimization solvers, Lingo and Cplex. Our objective is to maximize the incomes based on T2A and to minimize the cost to use supplementary beds. As a result of this model, the bed allocation planning calculated from the best objective value is presented.

http://www.sciencedirect.com/science/article/pii/S0378778812004987; International audience; Inhabitant's decisions and actions have a strong impact on the energy consumption and are an important factor in reducing energy consumption and in modelling future energy trends. Energy simulations that take into account inhabitants' behaviour are benchmarked at office buildings using controlled activity profiles and predefined scenarios. In this paper we have proposed a co-simulation environment for energy smart homes that takes into account inhabitants' dynamic and social behaviour. Based on this kind of complex behaviour, the setpoints for different controllers are adjusted in the physical simulator. In this platform, human behaviour is modelled using the Brahms environment and the thermal model and controllers for different appliances are modelled as a physical simulator. The thermal model computes the temperature decrease/increase in a room based on the contextual information resulting from the behaviour simulator. This information is then given to the controller to act upon.

International audience; A thermal transient numerical model (M3D) which considers the three-dimensional heat transfer through the envelope of a room and the sun patch through a window has been developed and validated in a recent paper. The use of a refined spatial and temporal discretization allows considering more precise interactions between the sun patch projection with the structure and quick time perturbations in the stresses. This is particularly necessary for highly insulated and low energy consumption buildings. In this new paper, M3D is subsequently transformed to simpler configurations, close to classical modelling thermal building simulation software that neglects the sun patch and the 3D heat transfer, in order to quantify the main contributions of this model. A first configuration is to consider one-dimensional heat conduction for the envelope and the transmitted solar radiation is only projected onto the floor (M1D). A second configuration considers also one-dimensional heat conduction but the transmitted beam radiation falls on each wall or floor that is impacted (M1D,sp). Comparison between experimental data and numerical results of these three models shows, as expected, that M1D and M1D,sp are less accurate than M3D. This is particularly true when wanting to evaluate surface temperature distributions or heating power evolution in winter.

International audience; Overlong waiting time in emergency services is an important matter which has negative influence on healthcare quality. This problem can be resolved, improving emergency services using modeling and discrete event simulation of system process. In this paper, a simulation model is designed to represent the patient visit process by using respectively IDS Scheer ARIS and Rockwell Arena. This simulation model can help us to identify process bottlenecks, and adjust resources allocation or staff dimensioning without disturbing the actual system. For the purpose of reducing waiting time in emergency departments, Doctor's efficiency improvement and Quick Pass process, are proposed and experimented as two new solutions. In addition to simulation results, we summarize some advantages and shortcomings observed during our development work for future use of ARIS and Arena. This work was based on the Emergency Department at Saint Joseph and Saint Luc Hospital in Lyon, France.

International audience; Energy waste due to inhabitants' behaviour in residential buildings has emerged as a potential research area due to the increasing worldwide population and growing energy needs. However, existing approaches for simulating energy consumption are mainly limited to office buildings and are based on static profiles. In this paper we propose a 4-step co-simulation methodology to assess how inhabitants' interactions with household appliances affect energy consumption. The approach is validated using a case study showing how human activities influence the energy consumption patterns of a refrigerator. The fridge was specifically chosen because it is a high energy-consuming appliance that is strongly affected by inhabitants' behaviours. In addition, modelling the fridge is nontrivial, and in choosing this appliance we show that it is possible to apply the approach to less complex appliances. A co-simulation approach is adopted with the fridge being physically modelled in Matlab and with human behaviour being modelled in the Brahms language and simulation environment. The consumption distribution from the simulated scenario is compared with the actual distribution (using data from a consumption database), to find optimum values of tuning parameters with less than 10% variation. This methodology enables us to simulate how human behaviours affect energy appliance consumption.

International audience; In this paper, we deal with a drug delivery problem in a French homecare. The carriers are assigned to specific areas and must visit each patient once a day while minimizing the total travelled distance. In this context, we propose to explore four strategies of delivery: (i) starting deliveries when a specified number of deliveries is achieved, (ii) starting deliveries if a specified distance is reached regarding to the planned deliveries, (iii) starting deliveries on a fixed number of deliveries per carrier and, (vi) starting deliveries on fixed hours. We introduce a mixed linear program which takes into account various constraints and minimize the total travelled distance. The results obtained for each strategy are compared in order to identify which one is the most efficient to solve the drug delivery problem at the homecare.

International audience; The complexity of the Emergency Supply Chains makes its management very difficult. Hence, we present in this article a comprehensive view of the French emergency supply chain (ESC), we propose an ad hoc relationship model between actors, and a GRAI grid-based model to initiate a new approach for controlling the ESC deficiencies, especially related to decision making. Throughout the article, we discuss the interest of the use of enterprise modelling to model the ESC. We discuss too, the characterization of the different issues related to the steering of the ESC. A literature review based on the GRAI grid model is proposed and discussed too. The GRAI method is used here because it presents the advantage of using the theory of complex systems, and it provides a dynamic model of an organization by focusing on decision-making and decisions communication.

International audience; The purpose of this paper is two-fold. Firstly, to show the interest of modeling emergency care networks. We then characterize the different issues related to the steering of the Emergency Supply Chain and positioning the literature dedicated to health emergency issues. This allows to propose a modeling of the Emergency network and to support the development of long-lasting solutions to Emergency supply chain problems.

Regarding the considerable increase of patient visits to healthcare services, especially in the Emergency Department (ED), high and rising healthcare costs continuously impact on the budget of hospitals. Optimizing the use of material and human resources is getting more and more urgent to maintain healthcare quality. In this thesis, we present appropriate solutions making for ED to improve healthcare delivery in a comprehensive vision integrating all interactions between different actors and between different patient flows. The first part concerns the analysis of ED's organizational issues in the context of French healthcare system. The second part of this thesis presents modeling and simulation of emergency treatment process, two improvement propositions are experimented using discrete events simulation tools. The third part focuses on hospital beds management; a mathematical model is developed in order to optimize the utilization of bed resource. The last part of this thesis presents firstly a detailed simulation model in which has been integrated an inpatient beds planning, simulating a scenario that the emergency department knows about inpatient beds availability in care units. Secondly, a decision support tool coupling simulation model and mathematic optimization model is discussed., L'exigence des soins à apporter aux patients accueillis aux urgences combinée au contexte économique impose aux établissements hospitaliers, surtout aux SAU, des décisions rapides ainsi que l'optimisation de l'emploi des ressources matérielles et humaines pour maintenir la fluidité des patients sans pour autant compromettre la qualité de soins. Nous proposons à travers ce mémoire de thèse des solutions appropriées aux services d'urgence permettant d'améliorer la prise en charge des urgences dans une vision globale intégrant l'ensemble des interactions entre les différents acteurs et entre les différents flux de patients. La première partie concerne l'analyse des problématiques de la filière des urgences dans un contexte socio-économique du système de santé français. La deuxième partie présente la modélisation et la simulation du processus de prise en charge des urgences, ainsi que deux propositions d'amélioration (Efficacité accrue du médecin et Parcours rapide) expérimentées. La troisième partie se focalise sur la gestion des lits d'hospitalisation en aval des urgences, un modèle mathématique est développé par la suite pour optimiser la planification des lits en tenant compte les flux des patient urgents et programmés. En dernier, nous étudions l'efficacité de la connaissance des disponibilités en lits d'aval au service d'urgence, et la planification des admissions en aval des urgences par le biais du couplage de méthodes de Simulation et de Recherche opérationnelle.

Regarding the considerable increase of patient visits to healthcare services, especially in the Emergency Department (ED), high and rising healthcare costs continuously impact on the budget of hospitals. Optimizing the use of material and human resources is getting more and more urgent to maintain healthcare quality. In this thesis, we present appropriate solutions making for ED to improve healthcare delivery in a comprehensive vision integrating all interactions between different actors and between different patient flows. The first part concerns the analysis of ED's organizational issues in the context of French healthcare system. The second part of this thesis presents modeling and simulation of emergency treatment process, two improvement propositions are experimented using discrete events simulation tools. The third part focuses on hospital beds management; a mathematical model is developed in order to optimize the utilization of bed resource. The last part of this thesis presents firstly a detailed simulation model in which has been integrated an inpatient beds planning, simulating a scenario that the emergency department knows about inpatient beds availability in care units. Secondly, a decision support tool coupling simulation model and mathematic optimization model is discussed., L'exigence des soins à apporter aux patients accueillis aux urgences combinée au contexte économique impose aux établissements hospitaliers, surtout aux SAU, des décisions rapides ainsi que l'optimisation de l'emploi des ressources matérielles et humaines pour maintenir la fluidité des patients sans pour autant compromettre la qualité de soins. Nous proposons à travers ce mémoire de thèse des solutions appropriées aux services d'urgence permettant d'améliorer la prise en charge des urgences dans une vision globale intégrant l'ensemble des interactions entre les différents acteurs et entre les différents flux de patients. La première partie concerne l'analyse des problématiques de la filière des urgences dans un contexte socio-économique du système de santé français. La deuxième partie présente la modélisation et la simulation du processus de prise en charge des urgences, ainsi que deux propositions d'amélioration (Efficacité accrue du médecin et Parcours rapide) expérimentées. La troisième partie se focalise sur la gestion des lits d'hospitalisation en aval des urgences, un modèle mathématique est développé par la suite pour optimiser la planification des lits en tenant compte les flux des patient urgents et programmés. En dernier, nous étudions l'efficacité de la connaissance des disponibilités en lits d'aval au service d'urgence, et la planification des admissions en aval des urgences par le biais du couplage de méthodes de Simulation et de Recherche opérationnelle.

La problématique de la réorganisation des systèmes de production a depuis longtemps débordé le simple domaine de la production industrielle. Dans le cas des systèmes de santé les impératifs de maîtrise de dépenses et de maintien d'un système de soin de qualité, les a conduit à devoir se remettre en cause et à évoluer vers des systèmes proches de leurs voisins industriels. Nous proposons l'utilisation de la modélisation d'entreprise et de la simulation de flux pour l'analyse et la conduite de projet de réorganisation pour le pilotage des Services d'Accueil des Urgences

10; Face à des restrictions budgétaires et à un besoin d'amélioration de la productivité, les systèmes hospitaliers se trouvent confrontés à la problématique de mutualisation des ressources dans la mesure où ils doivent réaliser des économies d'échelle tout en garantissant la qualité des soins prodigués aux patients. Cet article traite de la planification des lits et propose un outil d'aide à la décision permettant d'établir le planning d'affectation de lits mutualisés d'un établissement de soins tout en considérant deux catégories de patients, programmés et non programmés.

Overlong waiting time in emergency services is an important matter which has negative influence on healthcare quality. This problem can be resolved, improving emergency services using modeling and discrete event simulation of system process. In this paper, a simulation model is designed to represent the patient visit process by using respectively IDS Scheer ARIS and Rockwell Arena. This simulation model can help us to identify process bottlenecks, and adjust resources allocation or staff dimensioning without disturbing the actual system. For the purpose of reducing waiting time in emergency departments, Doctor's efficiency improvement and Quick Pass process, are proposed and experimented as two new solutions. In addition to simulation results, we summarize some advantages and shortcomings observed during our development work for future use of ARIS and Arena. This work was based on the Emergency Department at Saint Joseph and Saint Luc Hospital in Lyon, France.

Article étendue précédemment publié dans la conférence GISEH 2006; National audience; L'objet de cet article est de montrer l'intérêt du couplage des méthodes de modélisation d'entreprise et de simulation de flux, pour la validation des décisions dans le cadre de la réorganisation et le pilotage des processus de prise en charge des patients aux urgences. Nous présentons au travers de cet article la démarche suivie pour la réorganisation, puis les résultats obtenus lors du déploiement de la démarche. La finalité du travail est de tester et valider différentes stratégies de pilotage pour minimiser les durées de séjour et les temps d'attente des patients aux services d'urgences, élément de l'efficience de la prise en charge. Nous détaillons cette démarche à partir d‘une expérience d'accompagnement du service d'urgence du Centre Hospitalier Universitaire de Saint Etienne.

International audience; L'amélioration de la gestion d'un service d'urgences pose des problèmes délicats d'ordonnancement des ressources matérielles et humaines, et de pilotage des flux patients. Nous avons modélisé et simulé le processus de prise en charge des patients d'un service d'urgences en intégrant les ressources allouées. Les résultats montrent que notre modèle reflète bien la réalité, les données issues du diagnostic nous permettent d'identifier certains goulots d'étranglement dans le service étudié. Une proposition visant à la création d'un parcours rapide est discutée.

International audience; Recherchant la diminution des coûts par une meilleure utilisation de leurs ressources, les hôpitaux se dirigent vers la mutualisation des moyens matériels et humains. Ce papier s'intéresse à la planification des lits dans un contexte de demande de soins croissante et quand la capacité de la ressource lit est partagée entre deux types de patients : des patients programmés et des patients non programmés issus entre autre des urgences. Dans la résolution de cette problématique, nous proposons une méthode d'aide à la décision concernant la planification des lits ainsi que, la prise en compte de l'urgence dans le planning des lits déjà établi en minimisant son coût d'insertion. Ces travaux nous permettent de démontrer que des méthodes d'analyse et des outils de résolution issus du domaine industriel peuvent être appliqués au domaine hospitalier.

International audience; L'objet de cet article est de montrer l'intérêt du couplage des méthodes de modélisation d'entreprise et de simulation de flux, pour la validation des décisions dans le cadre de la réorganisation du pilotage du processus de prise en charge des patients aux urgences. Nous présentons au travers de l'article la démarche suivie pour la réorganisation. La finalité du travail est de minimiser les durées de séjour et les temps d'attente des patients, tout en assurant une prise en charge rapide, adaptée et de qualité. Nous détaillons cette démarche à partir d‘une expérience d'accompagnement du service d'urgences du Centre Hospitalier Universitaire de Saint Etienne.