April 23, 2024
In 2021, during the peak of the third wave of the COVID-19 pandemic, the health-care system’s capacity was stretched and hospitals across Canada relied on each other to share resources and provide care. To help in decision-making, team members from London Health Sciences Centre (LHSC), Ivey Business School and King’s University College developed a simulation model to help LHSC leaders make decisions on resources and capacity to ensure the hospital was ready to accept inbound patient transfers from outside the hospital’s catchment area, including Toronto and Manitoba.
The pandemic required collaboration across the health-care system to ensure capacity was balanced across hospitals while maintaining the ability to care for non-COVID patients. In addition to strategies like having field hospitals at the ready, patient transfers between hospitals were critical to managing the pandemic response. To enable the most efficient use of resources during a crucial time, LHSC leaders needed a solution.
Building on previous partnership work, hospital leadership saw an opportunity to work with a team of researchers from Ivey Business School and King’s University College. The collaboration resulted in the development of a Monte Carlo simulation tool designed to predict the likelihood of whether the hospital would be over capacity in responding to several COVID-19 related impacts, including changes in hospital admission rates, managing the impact of COVID-19 outbreaks and balancing the COVID-19 response with planned hospital activity.
The tool, created in Excel so that any hospital could use it, helped forecast the usage of Critical Care and Medicine Unit beds over a one-week period based on data from the previous week, including admission rate and average length-of-stay for both COVID-19 and non-COVID-19 patients. The tool also factored in assumptions about future arrivals of patients from outside the region to predict capacity needs and whether additional beds dedicated solely for COVID-19 patients would be required.
“The tool allowed us to maintain optimal care for all LHSC units by making decisions grounded in real-time data,” shared Tim Rice, Senior Director, Victoria Hospital at LHSC. “By inputting this data into the model, the impact to overall hospital bed capacity was better understood and provided LHSC leaders the information they needed to make objective decisions, including the resources required to meet the ongoing demands of the pandemic.”
When Manitoba hospitals required support from LHSC at a time where they were already supporting both the London region and requests from Toronto hospitals, the team was prepared and confident in making decisions on how many patients LHSC had the capacity to accept from other hospitals and how to most effectively use hospital resources.
“The tool serves as a future resource for emergency preparedness and new iterations of the model are in development to help with ongoing capacity planning, ” said Rice. “It is our hope that the legacy of this partnership will live on in the future work it supports.”
This work was recently published in BMC Public Health.
The research team included Mehmet A. Begen, Associate Professor, Management Science, Ivey Business School at Western University; Felipe F. Rodrigues, Assistant Professor, Operations Management and Analytics at King’s University College at Western University; Tim Rice, Senior Director, Victoria Hospital at London Health Science Centre; and Gregory S. Zaric, Professor, Management Science, Ivey Business School at Western University.