Managing Hospital Capacity: Achievements and Lessons from the COVID-19 Pandemic

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic challenged health care systems in an unprecedented way. Due to the enormous amount of hospital ward and intensive care unit (ICU) admissions, regular care came to a standstill, thereby overcrowding ICUs and endangering (regular and COVID-19-related) critical care. Acute care coordination centers were set up to safely manage the influx of COVID-19 patients. Furthermore, treatments requiring ICU surveillance were postponed leading to increased waiting lists. Hypothesis: A coordination center organizing patient transfers and admissions could reduce overcrowding and optimize in-hospital capacity. Methods: The acute lack of hospital capacity urged the region West-Netherlands to form a new regional system for patient triage and transfer: the Regional Capacity and Patient Transfer Service (RCPS). By combining hospital capacity data and a new method of triage and transfer, the RCPS was able to effectively select patients for transfer to other hospitals within the region or, in close collaboration with the National Capacity and Patient Transfer Service (LCPS), transfer patients to hospitals in other regions within the Netherlands. Results: From March 2020 through December 2021 (22 months), the RCPS West-Netherlands was requested to transfer 2,434 COVID-19 patients. After adequate triage, 1,720 patients with a mean age of 62 (SD = 13) years were transferred with the help of the RCPS West-Netherlands. This concerned 1,166 ward patients (68%) and 554 ICU patients (32%). Overcrowded hospitals were relieved by transferring these patients to hospitals with higher capacity. Conclusion: The health care system in the region West-Netherlands benefitted from the RCPS for both ward and ICU occupation. Due to the coordination by the RCPS, regional ICU occupation never exceeded the maximal ICU capacity, and therefore patients in need for acute direct care could always be admitted at the ICU. The presented method can be useful in reducing the waiting lists caused by the delayed care and for coordination and transfer of patients with new variants or other infectious diseases in the future.

Application of a Human Factors Systems Approach to Healthcare Control Centres for Managing Patient Flow: A Scoping Review

“…At the most extreme levels, ICCs are established to deal exclusively with situations beyond BAU—mostly MCM, although we found two papers covering ER [ 73 , 74 ] and three covering SM [ 56 , 57 , 75 ]. ICCs are usually closely coupled with outside stakeholders and agencies who manage other aspects of incident response.…”

Large-scale real-life implementation of technology-enabled care to maximize hospitals' medical surge preparedness during future infectious disease outbreaks and winter seasons: a viewpoint

“…Hospitals' medical surge preparedness or surge capacity plays a significant role in reducing mortalities in case of disasters and emergencies ( 59 – 61 ). Several models were developed including transportation of patients from one facility to another hospital or even relocating surgical services to satellite hospitals to increase theater and critical care capacity ( 2 , 60 , 62 , 63 ). As in several other countries, a hospital contingency plan has been implemented in Belgium since the start of the COVID-19 pandemic ( 64 – 66 ).…”

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis

“…The COVID-19 outbreak increased the short-term inpatient load, resulting in a lack of hospital capacity [ 2 , 3 ]. Hospitals tried to manage the increase in hospitalisations by cancelling the admission of regular care [ 3 ]. To overcome the extra needed care of COVID-19 patients, nurses and physicians were stretched during the pandemic [ 4 ].…”

“…On March 11, 2020, the outbreak of the coronavirus disease (COVID- 19) was declared by the World Health Organization (WHO) as a global pandemic [1]. The COVID-19 outbreak increased the short-term inpatient load, resulting in a lack of hospital capacity [2,3]. Hospitals tried to manage the increase in hospitalisations by cancelling the admission of regular care [3].…”