Bracing for the Next Surge

Researchers at Oregon State University

Researchers at Oregon State University, with colleagues at North Carolina
State University, are working to better understand the decision-making processes of hospital systems before, during, and after the COVID-19 pandemic. Their goal is to provide tools to help hospitals better manage medical surge capacity for future pandemics and other mass casualty events.

“Our efforts should lead to better understanding of how hospital systems can mount an effective response to these major disturbances,” said Joseph Agor, assistant professor of industrial engineering at Oregon State.

Supported by a Rapid Response Research grant from the National Science Foundation, the group will collect and analyze data from two hospital systems — Samaritan Health Services in Oregon and MedStar Health System in the Washington, D.C., metro region — to document operational changes, policies, and practices deployed to manage the surge of patients.

Agor is leading efforts with Samaritan, a Corvallis-based, not-for-profit, five-hospital system with 126 outpatient clinics and 5,500 employees caring for nearly 300,000 residents in Oregon’s Benton, Lincoln, and Linn counties.

The team will collect qualitative and quantitative data to gain insights into surge capacity preparations, as well as real-time operational adjustments for the COVID-19 pandemic, and characterize the impact of the surge on health care utilization patterns of non-coronavirus patients. They’ll also look at pre-pandemic planning guidelines, real-time changes in intensive care units and hospital bed capacity allocation, staffing, equipment availability (including personal protective equipment and testing equipment), and other hospital, state, and federal interventions.

“We expect this data to lead to knowledge, through better models and simulation, that can improve the response to future pandemics,” Agor said. The team hopes to answer three main questions.

First, what are the changes in demand patterns to the health care system? When the surges of patients started, hospitals like Samaritan enacted operational policies such as canceling elective surgeries to increase bed capacity, if needed.

“We want to look at the demand patterns pre-pandemic, during the response, and after it’s over,” Agor said. “We want to quantify and isolate changes in health-seeking behaviors so we can better predict what might happen if there’s another outbreak.”

The second question is around what practices are put in place to manage surge.

“Managing surge boils down to increasing capacity, including beds, staff, and equipment such as ventilators and PPE,” Agor said. “We seek to understand how systems are increasing capacity while dealing with staffing challenges and equipment shortages. This may happen through things like increased use of telehealth, calling in retired staff, and releasing noncritical patients earlier than usual.”

The final question researchers hope to answer is how patient outcomes are impacted.

“Hospital resources are stretched to their limits to treat infected patients during a pandemic,” Agor said. “This will impact the outcomes of other, non-COVID patients.” This includes patients seeking treatment for unexpected needs, as well as chronic patients who need to visit their doctors regularly.

“Our medical personnel and frontline physicians are absolutely great at what they do,” Agor said. “We can’t ask our physicians and our nurses to take their focus off patients to try to balance the system. As an engineer, I can help them do that so they can do what they do best, take care of patients.”

Sept. 25, 2020