Option appraisal for enhancing covid-20 care

Introduction
GCC commissioned an analysis of the care flow process and a simulation of the operation of the hospital working when it was working at full capacity (with 250 patients arriving every week). The care process is shown in Figure 1. The simulation of hospital activities is in the file covid20.s8.

Seventy new beds have been made available to the hospital, and they can be shared between the “recovery ward”, “high dependency unit” and “intensive care unit”.

You have been given two key tasks:

1. to describe the logic of the model, particularly in the areas of resources available to the recovery ward and the HDU and the ICU;
2. To advise management on the best way to distribute the 70 new beds across the three wards so as to minimize transfers to other hospitals and to maximize successful discharges through the hospital.

The care process

Assignment 1 described the basic care process; note that this is a simplification of actual care where it is possible for some patients to take more complex routs through the hospital system. Further data describing the durations and capacities of key activities are noted below. When no the covid-20 wards are full, patients are placed on another ward; from that ward they might be discharged or transferred to the HDU if their condition deteriorates. If the HDU is full, the patient could be place in the ICU if there is a spare bed. When the ICU is full, patients requiring this level of care have to be transferred to another hospital in a different region. An early study suggested that 35% of referrals result in admissions; about 55% of hospital admissions require a stay on the HDU and 40% will need some time on the HDU and also ICU; 15% of the patients admitted died. Before any patient is discharged they spend a few days on the recovery ward with an emphasis on occupational therapy and physiotherapy.

Figure 2 The care process

Scenarios

1. Describe the logical flow of the simul8 model provided, with a special emphasis on the resources available in the recovery ward, the HDU and the ICU.