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

O1: With the cancellation of elective surgeries, a hospital can recoup losses in routine patient treatment while providing resources to the COVID-19 response

OutbreakOutbreak Insight 1The 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)

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