Models for Assessing Strategies for Improving Hospital Capacity for Handling Patients during a Pandemic
Models for Assessing Strategies for Improving Hospital Capacity for Handling Patients during a Pandemic
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DOI：
10.1017/dmp.2022.12
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发表时间：
2022-01-10
影响因子：
2.7
通讯作者：
Kirsch, Thomas D.
中科院分区：
文献类型：
--
作者：
Shahverdi, Bahar;Miller-Hooks, Elise;Kirsch, Thomas D.
目的：这项研究的目的是调查与常规紧急情况和大流行（COVID-19）患者的紧急护理相关的关键医院单位的表现。方法：该研究是使用全医院，资源约束，基于患者的，随机，离散事件的，模拟模型的仿制模型，该模型是美国美国高等教育医院，服务常规紧急情况和COVID-19患者。进行了系统设计的数值实验，以提供可普遍的见解，以了解医院功能如何受到在不断变化的大流行状况下，从准备将其所有资源转换为大流行护理的大流行状况下，在不断变化的大流行状况下，如何受到专门指定的护理路径的护理影响。结果：提供了一些见解。例如，每天减少ICU住院时间的每天都会使重症监护病房的患者吞吐量增加高达24％，而高价为19的每日患者到达水平。还描述了5种特定干预措施的潜力和2种关键的护理策略转变，以显着增加医院的能力。结论：这些估计使医院能够重新利用空间，修改操作，实施危机标准，与其他医疗保健设施合作或要求外部支持，从而增加了到达患者在需要1时找到开放人员的床的可能性。
Objective: The aim of this study was to investigate the performance of key hospital units associated with emergency care of both routine emergency and pandemic (COVID-19) patients under capacity enhancing strategies. Methods: This investigation was conducted using whole-hospital, resource-constrained, patient-based, stochastic, discrete-event, simulation models of a generic 200-bed urban U.S. tertiary hospital serving routine emergency and COVID-19 patients. Systematically designed numerical experiments were conducted to provide generalizable insights into how hospital functionality may be affected by the care of COVID-19 pandemic patients along specially designated care paths, under changing pandemic situations, from getting ready to turning all of its resources to pandemic care. Results: Several insights are presented. For example, each day of reduction in average ICU length of stay increases intensive care unit patient throughput by up to 24% for high COVID-19 daily patient arrival levels. The potential of 5 specific interventions and 2 critical shifts in care strategies to significantly increase hospital capacity is also described. Conclusions: These estimates enable hospitals to repurpose space, modify operations, implement crisis standards of care, collaborate with other health care facilities, or request external support, thereby increasing the likelihood that arriving patients will find an open staffed bed when 1 is needed.