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Option apprasial for enhancing covid-20 care

Assignment 3 Autumn 2020

 商业分析论文代写 This enhanced model should then be used to assess the options for preparation for a possible second wave of infection or other future epidemics.

Introduction

In Assignment 2 you worked in a group to develop a basic Simul8 model of the current GCC hospital and its arrangements for covid-20 patients.  In Assignment 3 you should work individually to enhance the model to accommodate more detailed information.  This enhanced model should then be used to assess the options for preparation for a possible second wave of infection or other future epidemics.

Demand for care

Detailed data describing the confirmed cases of infection for the first wave of infection are available (covid 20 outcomes.xlsx).  The data describe the key characteristics of the patients, their treatment and outcomes.  Future demand is impossible to predict.  Hopefully there will be no second wave or similar infection.  But we need to be prepared so a selection of demand scenarios need to be examined, and possible mitigating actions.

The care process  商业分析论文代写

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

Table 2 Activity durations and capacities (* times based on studies of hospitals in the UK)

Historical performance  商业分析论文代写

During the covid-20 epidemic the region had 2386 confirmed cases referred for possible treatment, of which 2372 had been discharged by the end of data collection period.  There were 729 hospital admissions, some of whom required intensive care.  For most of the time, the hospital coped, as reflected in the mean utilisations.  But the mean figures are misleading: there were several weeks when the demand for some services exceeded supply resulting in patients being placed on non-specialist covid wards or transferred to ICU’s in other regions.

The patient pathways have been simplified. For example, in practice a few patients may move backwards and forwards between the wards but in this exercise you should ignore the possibility of patients following different, more complex sequences of activity.

Table 2 Staff utilisations (* mean utilisation for the whole 26 weeks)

Scenarios  商业分析论文代写

1.Levels of demand

A number of epidemiological scenarios should be considered:

• demand 10% greater than that experienced in the peak weeks of the first wave of infection
• 50% increase in demand
• 100% increase in demand

2.Limited vaccine

Although a general vaccine, suitable for the whole population might be developed, it is feared that the vaccine might have more limited application.  The side effects of some potential vaccines could be severe and prevent their use for patients in higher risk groups.  The vaccine might be given to all of the population in risk group 1; it is expected that it would reduce the infection rate by 80% for those vaccinated.

3.Enhanced intensive care

Advances in the use of therapeutic drugs and care protocols may help improve the outcomes for patients and reduce the length of stay by 30% on average in the HDU and ICU.

4.Age related shielding

It has been suggested that in a second wave of infection, a more targeted form of lockdown might be implemented, with additional constraints on older people.  Although it might be unpopular, this policy might reduce infections amongst those aged over 60 years by 50%.

Management options

1.Additional HDU and ICU capacity

Additional HDU and/or ICU capacity could be provided by reallocating other resources from elsewhere in the hospital.  This involves retraining some staff and reconfiguring some care areas (e.g. surgery recovery areas may be adapted).  Typically an extra ICU bed requires twice the resource of an HDU bed.  However, reallocating such resources implies reducing other hospital services and notably increasing waiting times for many non-covid patients.

2.Additional ward beds

It is easier to provide additional capacity for the covid-20 and recovery wards.  However, there will still be an impact on the ability to care for non-covid patients.

Tasks  商业分析论文代写

1.Enhance the Simul8 model of Assignment 2 in response to feedback from the presentation and also incorporating the additional information provided in this assignment.

2.Validate the model using the various historical data.

3.Analyse the confirmed cases data from April-June 2020 to determine the demand.

4.Use the enhanced model to analyse the various scenarios and management options.

5.Write a report a report containing:

• summary: very briefly stating the key objectives, methods results and recommendations
• contents page
• analysis of the demand
• description of your model covid20 highlighting the key features (this may include material from the presentation of Assignment 2 but emphasising any enhancements)
• validation of the model covid20
• analyses of the scenarios and management options
• suggestions of further analyses and other possible options if you had the necessary time and data
• recommendations: interpreting the results of the analyses and the consequent suggestions for management action

6.Provide a copy of your Simul8 model covid20.S8

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