Dissertation (Ph.D.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 295 pages. Includes vita. Includes bibliographical references.

Emergency managers are often faced with the toughest decisions that can ever be made, people's lives hang in the balance. Nevertheless, these tough decisions have to be made, and made quickly. There is usually too much information to process to make the best decisions. Decision support systems can relieve a significant amount of this onus, making decision while considering the complex interweaving of constraints and resources that define the boundary of the problem. We study these complex emergency management, approaching the problem with discrete optimization. Using our operational research knowledge to model mass casualty incidents, we seek to provide solutions and insights for the emergency managers. This dissertation proposes a novel deterministic model to optimize the casualty transportation and treatment decisions in response to a MCI. This deterministic model expands on current state of the art by; (1) including multiple dynamic resources that impact the various interconnected decisions, (2) further refining a survival function to measure expected survivors, (3) defining novel objective functions that consider competing priorities, including maximizing survivors and balancing equity, and finally (4) developing a MCI response simulation that provides insights to how optimization models could be used as decision-support mechanisms. / Doctor of Philosophy / Emergency managers are often faced with the toughest decisions that can ever be made, people's lives hang in the balance. Nevertheless, these tough decisions have to be made, and made quickly. But to make the best decisions, there is usually too much information to process. Computers and support tools can relieve a significant amount of this onus, making decision while considering the complex interweaving of constraints and resources that define the boundary of the problem. This dissertation provides a mathematical model that relates the important decisions made during a MCI response with the limited resources of the surrounding area. This mathematical model can be used to determine the best response decisions, such as where to send casualties and when to treat them. This model is also used to explore ideas of fairness and equity in casualty outcomes and examine what may lead in unfair response decisions. Finally, this dissertation uses a simulation to understand how this model could be used to not only plan the response, but also update the plan as you learn new information during the response roll-out.

In this thesis, we explore three critical emergency logistics problems faced by healthcare and humanitarian relief service providers for short-term post-disaster management. In the first manuscript, we investigate various integration mechanisms (fully integrated horizontal-vertical, horizontal, and vertical resource sharing mechanisms) following a natural disaster for a multi-type whole blood-derived platelets, multi-patient logistics network. The goal is to reduce the amount of shortage and wastage of multi-blood-group of platelets in the response phase of relief logistics operations. To solve the logistics model for a large scale problem, we develop a hybrid exact solution approach involving an augmented epsilon-constraint and Lagrangian relaxation algorithms and demonstrate the model's applicability for a case study of an earthquake. Due to uncertainty in the number of injuries needing multi-type blood-derived platelets, we apply a robust optimization version of the proposed model which captures the expected performance of the system. The results show that the performance of the platelets logistics network under coordinated and integrated mechanisms better control the level of shortage and wastage compared with that of a non-integrated network. In the second manuscript, we propose a two-stage casualty evacuation model that involves routing of patients with different injury levels during wildfires. The first stage deals with field hospital selection and the second stage determines the number of patients that can be transferred to the selected hospitals or shelters via different routes of the evacuation network. The goal of this model is to reduce the evacuation response time, which ultimately increase the number of evacuated people from evacuation assembly points under limited time windows. To solve the model for large-scale problems, we develop a two-step meta-heuristic algorithm. To consider multiple sources of uncertainty, a flexible robust approach considering the worst-case and expected performance of the system simultaneously is applied to handle any realization of the uncertain parameters. The results show that the fully coordinated evacuation model in which the vehicles can freely pick up and off-board the patients at different locations and are allowed to start their next operations without being forced to return to the departure point (evacuation assembly points) outperforms the non-coordinated and non-integrated evacuation models in terms of number of evacuated patients. In the third manuscript, we propose an integrated transportation and hospital capacity model to optimize the assignment of relevant medical resources to multi-level-injury patients in the time of a MCI. We develop a finite-horizon MDP to efficiently allocate resources and hospital capacities to injured people in a dynamic fashion under limited time horizon. We solve this model using the linear programming approach to ADP, and by developing a two-phase heuristics based on column generation algorithm. The results show better policies can be derived for allocating limited resources (i.e., vehicles) and hospital capacities to the injured people compared with the benchmark. Each paper makes a worthwhile contribution to the humanitarian relief operations literature and can help relief and healthcare providers optimize resource and service logistics by applying the proposed integration and coordination mechanisms.

This dissertation investigates the value of deep reinforcement learning (DRL) within an agent-based model (ABM) of a large open-air venue. The intent is to reduce civilian casualties in an active shooting incident (ASI). There has been a steady increase of ASIs in the United States of America for over 20 years, and some of the most casualty-producing events have been in open spaces and open-air venues. More research should be conducted within the field to help discover policies that can mitigate the threat of a shooter in extremis. This study uses the concept of dynamic signage, controlled by a DRL policy, to guide civilians away from the threat and toward a safe exit in the modeled environment. It was found that a well-trained DRL policy can significantly reduce civilian casualties as compared to baseline scenarios. Further, the DRL policy can assist decision makers in determining how many signs to use in an environment and where to place them. Finally, research using DRL in the ASI space can yield systems and policies that will help reduce the impact of active shooters during an incident.