Shahverdi Bahar, Miller-Hooks Elise, Tariverdi Mersedeh, Ghayoomi Hadi, Prentiss David, Kirsch Thomas D
Sid and Reva Dewberry Department of Civil, Environmental and Infrastructure Engineering, George Mason University, Fairfax, VA, USA.
The World Bank, Washington, DC, USA.
Disaster Med Public Health Prep. 2022 Jan 10;17:e110. doi: 10.1017/dmp.2022.12.
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.
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.
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.
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.
本研究旨在调查在能力提升策略下，与常规急诊和大流行（新冠病毒病）患者急诊护理相关的关键医院科室的表现。
本调查使用了一家拥有200张床位的美国城市三级综合医院的全院范围、资源受限、基于患者的随机离散事件模拟模型，该医院为常规急诊患者和新冠病毒病患者提供服务。进行了系统设计的数值实验，以提供可推广的见解，了解在不断变化的大流行情况下，从准备阶段到将所有资源转向大流行护理阶段，沿着专门指定的护理路径护理新冠病毒病大流行患者可能如何影响医院功能。
给出了一些见解。例如，对于新冠病毒病每日高患者到达量，平均重症监护病房住院时间每减少一天，重症监护病房患者通量最多可提高24%。还描述了5种特定干预措施和2种关键护理策略转变显著提高医院容量的潜力。
这些估计使医院能够重新利用空间、调整运营、实施危机护理标准、与其他医疗保健机构合作或请求外部支持，从而增加患者在需要时能够找到有空床位和医护人员的可能性。
