George Mason University  World Bank Group  Johns Hopkins University MASH-Pandemics

H1: COVID-19 designated hospitals can serve up to five times the number of COVID-19 patients compared with a similar facility accepting mixed patients

Graph1Initial OnsetBy using all available beds, nurses and doctors ordinarily assigned to routine patients for COVID-19 patient treatment, a > 300% increase in the number of COVID-19 patients served in a generic urban hospital at usual standards of care can be achieved. This increases to nearly 500% (an increase of 360% in ICU & 140% admitted) when crisis standards of care are permitted or a more efficient allocation of staff is utilized. 

More than double the number of COVID-19 patients at routine standards of care can be served before maximum service rates are reached. This increases an additional 50% when crisis standards of care are permitted. This can only be improved further with additional space (i.e. beds).

The base COVID-19 design model replicated a typical US urban 200-bed tertiary hospital with:

  • 20 ICU beds shared between COVID-19 and routine patient arrivals
  • 25 critical decision unit beds
  • 70 isolation rooms (taking 50 of the internal general ward (IGW) beds)
  • Separate COVID-19 entry
  • 10% COVID-19 patients to ICU with average 9-day stay in ICU (2.8 realized average ICU stay for routine patients)
  • Maximum service rates are reached when one or more key resource types (doctor, nurse or bed) are fully utilized.

Comparison hot spot models:

  • Hot Spot Design - Staff and space in Pre-op, SICU, PACU and 75% ED reassigned for ICU COVID-19 patients and in General Ward, Stepdown and 25% ED to admitted COVID-19 patients needing isolation
  • Hot Spot Design with Crisis Standards of Care - Nurses and doctors serve twice the patients as compared to routine standards of care
  • Hot Spot Design with Optimized Staff Assignment - Reallocated staff are optimally assigned based on expected utilization and skills, routine standards of care are maintained

COVID-19 Care Paths & Assumptions (pdf)

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