Optimization of the Casualties' Treatment Process: Blended Military Experiment

Entropy (Basel). 2020 Jun 25;22(6):706. doi: 10.3390/e22060706.

Abstract

At the battalion level, NATO ROLE1 medical treatment command focuses on the provision of primary health care being the very first physician and higher medical equipment intervention for casualty treatments. ROLE1 has paramount importance in casualty reductions, representing a complex system in current operations. This study deals with an experiment on the optimization of ROLE1 according to the key parameters of the numbers of physicians, the number of ambulances and the distance between ROLE1 and the current battlefield. The very first step in this study is to design and implement a model of current battlefield casualties. The model uses friction data generated from an already executed computer assisted exercise (CAX) while employing a constructive simulation to produce offense and defense scenarios on the flow of casualties. The next step in the study is to design and implement a model representing the transportation to ROLE1, its structure and behavior. The deterministic model of ROLE1, employing a system dynamics simulation paradigm, uses the previously generated casualty flows as the inputs representing human decision-making processes through the recorder CAX events. A factorial experimental design for the ROLE1 model revealed the recommended variants of the ROLE1 structure for both offensive and defensive operations. The overall recommendation is for the internal structure of ROLE1 to have three ambulances and three physicians for any kind of current operation and any distance between ROLE1 and the current battlefield within the limit of 20 min. This study provides novelty in the methodology of casualty estimations involving human decision-making factors as well as the optimization of medical treatment processes through experimentation with the process model.

Keywords: casualty treatment optimization; complex systems; system dynamics.