Capacity Planning for Elective Surgical Services post COVID-19

为应对COVID-19疫情，新斯科舍省卫生局（NSHA）于二零二零年三月中旬取消了择期手术服务，导致患者等候名单数量增加[1，2]。紧急程序正在进行中，一些基于优先级的紧急手术也在进行中（例如，只有等待> 4周的预期阴性结果的病例）。因此，新斯科舍省大多数需要手术治疗的病人的手术都“暂停”了。结合我省已有充分记录的部分择期手术等待时间较长的情况[3，4]，无论当前和未来COVID相关影响对我们的医疗保健系统的不确定性如何，都需要一种有效的策略来解决这一差距。 随着外科服务的重新开放，将出现对获得卫生系统资源的竞争需求，如手术室时间和住院床位。虽然有几项准则概述了重新开庭的要求和考虑，但了解具体法域的环境至关重要。需要克服的差距是什么？可以采取哪些工具和办法来解决这一差距？什么是最好的方法，以纳入临床适当性和优先顺序的方法？ 该项目的目的是通过提供能力规划预测和模型来探讨潜在的重新开放策略，以解决与COVID相关的择期手术积压问题。

In response to the COVID-19 pandemic, elective surgical services throughout The Nova Scotia Health Authority (NSHA) were cancelled mid-March 2020 resulting in increased patient waitlist volumes [1, 2]. Emergency procedures are proceeding, as is some urgent surgery based on priority banding (e.g. only cases where negative outcome expected with > 4 week wait). As a result, surgery for the majority of patients requiring surgical care in Nova Scotia is "on pause". Combined with the already well documented long wait times for some of these elective procedures in our province [3,4], an effective strategy to address this gap is required, regardless of the current and future uncertainty in COVID related implications for our health care system. As surgical services reopen there will be competing demands for access to health system resources such as operating room time and inpatient beds. While several guidelines exist outlining requirements and considerations for such reopening, knowledge of the jurisdiction-specific environment is critical. What is the gap to be overcome? What are the tools and approaches that could be taken to address the gap? What is the best way to incorporate clinical appropriateness and prioritization in the approach? The aim of this project is to address the COVID-related backlog of elective surgery by providing capacity planning forecasts and models to explore potential reopening strategies.