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We address the overcrowding problem in an emergency department (ED) by designing and developing a hybrid methodology that combines design thinking with discrete event simulation. The case study shows how the tested methodology led to a successful implementation of the proposed organizational change in less than 18   months, improving system KPIs (such as patients’ waiting time) and ED professionals’ quality of work. The results confirm a successful combination of the two approaches in practice, by showing (i) how to combine design thinking tools and simulation tools in different design phases (comprehension, abstraction, ideation, and testing), and (ii) how the two tools nurture each other reciprocally. The paper concludes with some final considerations regarding the use of simulation in organizational processes design.

Successful implementation of discrete event simulation: integrating design thinking and simulation approach in an emergency department