Hospital bed capacity management during the COVID-19 outbreak using system dynamics: A case study in Amol public hospitals, Iran

ABSTRACT

Nowadays proper management of hospital resources has played an important role in reducing the economic pressure on hospitals. Unprecedented challenges have arisen for healthcare systems including further resource constraints due to the Covid-19 pandemic. So different countries faced the low capacity of hospitals' resources to admit and care for patients during the crisis. Medical staff, beds and personal protective equipment are among the scarce resources in this period. In this study, the patient flow in public hospitals has been modeled using System Dynamics (SD) simulation to manage the available capacity of intensive care units (ICU) and wards during the COVID-19 period. The model has been implemented in Vensim PLE and verified for public hospitals in Amol, Iran. The results have shown that hospitals face bed shortages in the period coinciding with the growing incidence of COVID-19, being forced to cancel or delay the admission of selected patients and nonemergency surgeries. Different scenarios based on possible strategies for managing hospital bed capacities have been also evaluated. The best strategy is the one in which the allocated bed capacities to COVID-19 patients are altered based on infection rates during different stages of the pandemic, resulting the shortage of beds is postponed the most.

KEYWORDS:

• Bed capacity management
• system dynamics
• covid-19
• infection rate
• inpatient ward
• intensive care unit

Acknowledgment

The authors thank their colleagues from Amol Public Hospitals who provided insight and expertise that greatly assisted the research. The authors are grateful to the anonymous referees for their constructive comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Imam Khomeini

2 Imam Ali

3 Imam Reza

4 17-Shahrivar

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Soheil Hosseinzadeh

Soheil Hosseinzadeh is a PhD candidate in Industrial Management, University of Isfahan. He received his master degree from University of Tehran, college of Farabi. His research focuses on applications of Operations Research models for health care problems.

Saeedeh Ketabi

Saeedeh Ketabi is a Professor of Operations Research at Department of Management, University of Isfahan. She received her PhD in Applied Mathematics from University of Adelaide, Australia. Her research interest is mainly on the applications of Operations Research in Healthcare.

Arezoo Atighehchian

Arezoo Atighehchian received a B.S. and M.S. degree in industrial engineering from Isfahan University of Technology, Isfahan, Iran in 2003 and 2006. She received a PhD degree in Industrial Engineering from Tarbiat Modares University, Tehran, Iran in 2012. Her PhD thesis is about stochastic operating room scheduling. She is an assistant professor at the department of Industrial Engineering and Futures Studies, Faculty of engineering, University of Isfahan, Iran. Her main area of interest is health system optimization.

Roghieh Nazari

Roghieh Nazari is an Assistance professor in nursing department, Amol nursing school, Mazandaran university of medical sciences. Her research interests include nursing management, critical care management and critical care nursing.