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Managing Hospital Capacity: Achievements and Lessons from the COVID-19 Pandemic
Enrico R de Koning1, Mark J Boogers2, Saskia Lma Beeres2
1Regional Capacity and Patient Transfer Service (RCPS) West-Netherlands, Leiden, the Netherlands.
Insights
The Regional Capacity and Patient Transfer Service (RCPS) effectively managed COVID-19 patient transfers, preventing ICU overcrowding and reducing hospital waiting lists. This system optimized regional healthcare capacity during the pandemic.
Area of Science:
- Healthcare Management
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic severely strained healthcare systems, leading to ICU overcrowding and postponed regular care.
- Acute care coordination centers were established to manage patient influx and mitigate critical care risks.
Purpose of the Study:
- To evaluate the effectiveness of a regional coordination center in managing patient transfers and optimizing hospital capacity.
- To assess the impact of a new triage and transfer system on healthcare system strain during the pandemic.
Main Methods:
- The Regional Capacity and Patient Transfer Service (RCPS) was implemented in West-Netherlands, combining hospital capacity data with a novel triage and transfer protocol.
- The RCPS facilitated patient transfers within the region and, in collaboration with the National Capacity and Patient Transfer Service (LCPS), to other regions.
Main Results:
- Between March 2020 and December 2021, the RCPS managed 2,434 transfer requests for COVID-19 patients.
- 1,720 patients (mean age 62) were successfully transferred, including 1,166 ward patients (68%) and 554 ICU patients (32%), relieving overcrowded hospitals.
- Regional ICU occupancy remained below maximum capacity, ensuring admission for critical care patients.
Conclusions:
- The RCPS significantly benefited the West-Netherlands healthcare system by managing ward and ICU bed occupancy.
- The coordinated transfer system prevented ICU overload and ensured timely access to critical care.
- This model offers a valuable strategy for managing future patient surges, reducing waiting lists, and coordinating care for new infectious diseases.
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.
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