03: Serving each COVID-19 patient requires more of the hospital’s capacity than is needed to serve a single routine emergency patient
More resources are needed to serve the same number of emergency patients as in routine conditions with greater percentage of COVID-19 patients. Under routine conditions and no COVID-19 patients, the ICU bed utilization of the test hospital is 64% on average. With the ordinary emergency patient arrival rate of 200 patients per day, of which 5% are COVID-19 (10 COVID-19 patients per day), the ICU utilization increases significantly reaching 92% on average. A higher proportion (at 10%) of COVID-19 patients pushes the ICU bed utilization rate to 99%. With a greater percentage of patients with COVID-19, the ICU will need to turn away or find alternative resources to serve additional patients. Isolation room bed utilization simultaneously approaches 100% soon after the ICU reaches its maximum capacity. Thus, serving each COVID-19 patient requires more of the hospital’s capacity than is needed to serve a single routine emergency patient.
The base COVID-19 design model replicated a typical US urban 200-bed tertiary hospital with:
- 20 intensive care unit (ICU) beds shared between COVID-19 and routine patient arrivals
- 25 critical decision unit (CDU) beds
- 70 isolation rooms (taking 50 of the internal general ward (IGW) beds)
- 20 Emergency department (ED) 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.
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)