{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:36:23Z","timestamp":1785418583448,"version":"3.56.0"},"reference-count":45,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Systems"],"abstract":"<jats:p>This study presents a novel approach that integrates Discrete Event Simulation (DES) with Design of Experiments (DOE) techniques, framed within a stochastic optimization context and guided by a multi-objective goal programming methodology. The focus is on enhancing the operational efficiency of an emergency department (ED), illustrated through a real-world case study conducted in a Chilean hospital. The methodology employs Response Surface Methodology (RSM) to explore and optimize the impact of four critical resources: physicians, nurses, rooms, and radiologists. The response variable, formulated as a goal programming function, captures the aggregated patient flow time across four representative care tracks. The optimization process proceeded iteratively: early stages relied on linear approximations to identify promising improvement directions, while later phases applied a central composite design to model nonlinear interactions through a quadratic response surface. This progression revealed complex interdependencies among resources, ultimately leading to a local optimum. The proposed approach achieved a 50% reduction in the aggregated objective function and improved individual patient flow times by 7% to 26%. Compared to traditional metaheuristic methods, this simulation\u2013optimization framework offers a computationally efficient alternative, particularly valuable when the simulation model is complex and resource-intensive. These findings underscore the value of combining simulation, RSM, and multi-objective optimization to support data-driven decision-making in complex healthcare settings. The methodology not only improves ED performance but also offers a flexible and scalable framework adaptable to other clinical environments seeking resource optimization and operational improvement.<\/jats:p>","DOI":"10.3390\/systems13100912","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:29:17Z","timestamp":1760711357000},"page":"912","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Multi-Objective Simulation\u2013Optimization Framework for Emergency Department Efficiency Using RSM and Goal Programming"],"prefix":"10.3390","volume":"13","author":[{"given":"Felipe","family":"Baesler","sequence":"first","affiliation":[{"name":"Facultad de Ingenier\u00eda, Universidad San Sebasti\u00e1n, Concepci\u00f3n 4030000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1861-3062","authenticated-orcid":false,"given":"Oscar","family":"Cornejo","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering, College of Engineering, Universidad Cat\u00f3lica de la Sant\u00edsima Concepci\u00f3n, Concepci\u00f3n 4030000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5057-5377","authenticated-orcid":false,"given":"Carlos","family":"Obreque","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering, College of Engineering, Universidad del B\u00edo-B\u00edo, Concepci\u00f3n 4030000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3036-4329","authenticated-orcid":false,"given":"Eric","family":"Forcael","sequence":"additional","affiliation":[{"name":"Facultad de Ingenier\u00eda, Universidad San Sebasti\u00e1n, Concepci\u00f3n 4030000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6214-3473","authenticated-orcid":false,"given":"Rudy","family":"Carrasco","sequence":"additional","affiliation":[{"name":"Facultad de Ingenier\u00eda, Universidad San Sebasti\u00e1n, Concepci\u00f3n 4030000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Multi-scale Simulation of Complex Systems: A Perspective of Integrating Knowledge and Data","volume":"56","author":"Wang","year":"2024","journal-title":"ACM Comput. 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