PurposeForecasting outpatient volume during a significant security crisis can provide reasonable decision-making references for hospital managers to prevent sudden outbreaks and dispatch medical resources on time. Based on the background of standard hospital operation and Coronavirus disease (COVID-19) periods, this paper constructs a hybrid grey model to forecast the outpatient volume to provide foresight decision support for hospital decision-makers.Design/methodology/approachThis paper proposes an improved hybrid grey model for two stages. In the non-COVID-19 stage, the Aquila Optimizer (AO) is selected to optimize the modeling parameters. Fourier correction is applied to revise the stochastic disturbance. In the COVID-19 stage, this model adds the COVID-19 impact factor to improve the grey model forecasting results based on the dummy variables. The cycle of the dummy variables modifies the COVID-19 factor.FindingsThis paper tests the hybrid grey model on a large Chinese hospital in Jiangsu. The fitting MAPE is 2.48%, and the RMSE is 16463.69 in the training group. The test MAPE is 1.91%, and the RMSE is 9354.93 in the test group. The results of both groups are better than those of the comparative models.Originality/valueThe two-stage hybrid grey model can solve traditional hospitals' seasonal outpatient volume forecasting and provide future policy formulation references for sudden large-scale epidemics.