O1: With the cancellation of elective surgeries, a hospital can recoup losses in routine patient treatment while providing resources to the COVID-19 response
The added capacity for admitting patients with the cancellation of elective surgeries (presumed to be 75% of scheduled operations) enables the ED to serve 22% more patients, and results in a 18% greater overall hospital routine patient discharge, recouping losses in routine patient treatment from converting routine staff and space for treating COVID-19 patients. Additionally, more than half of the noncritical patients (ESI level 2-5) who could not receive timely service previously can now be served. The graph shows results for an average daily arrival of 200 routine and 105 COVID-19 patients per day, where routine standards of care are maintained.
The base hospital redesigned for COVID-19 model replicated a typical US urban 200-bed tertiary hospital with the following differences:
- 20 ICU beds shared between COVID-19
- 25 critical decision unit (CDU) beds
- 70 isolation rooms (taking 50 of the 200 internal general ward (IGW) beds)
- Separate COVID-19 entry
- 20 emergency department (ED) beds
- 10% COVID-19 patients to ICU with average 9-day stay in ICU (2.8 realized average ICU stay for routine patients)
- 75% cancellation in scheduled operations led to an average reduction from 112 to 28 weekly surgical patients
The base hospital for routine conditions model replicated the same typical US urban 200-bed tertiary hospital but with:
- 20 ICU beds for routine patients
- No CDU or isolation beds
- No COVID-19 entry
- 200 internal general ward (IGW) beds
- 40 ED beds
COVID-19 Care Paths & Assumptions (pdf)