Forecasting ward-level bed requirements to aid pandemic resource planning: Lessons learned and future directions.

IF 2.3 3区 医学 Q2 HEALTH POLICY & SERVICES
Health Care Management Science Pub Date : 2023-09-01 Epub Date: 2023-05-18 DOI:10.1007/s10729-023-09639-2
Michael R Johnson, Hiten Naik, Wei Siang Chan, Jesse Greiner, Matt Michaleski, Dong Liu, Bruno Silvestre, Ian P McCarthy
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引用次数: 0

Abstract

During the COVID-19 pandemic, there has been considerable research on how regional and country-level forecasting can be used to anticipate required hospital resources. We add to and build on this work by focusing on ward-level forecasting and planning tools for hospital staff during the pandemic. We present an assessment, validation, and deployment of a working prototype forecasting tool used within a modified Traffic Control Bundling (TCB) protocol for resource planning during the pandemic. We compare statistical and machine learning forecasting methods and their accuracy at one of the largest hospitals (Vancouver General Hospital) in Canada against a medium-sized hospital (St. Paul's Hospital) in Vancouver, Canada through the first three waves of the COVID-19 pandemic in the province of British Columbia. Our results confirm that traditional statistical and machine learning (ML) forecasting methods can provide valuable ward-level forecasting to aid in decision-making for pandemic resource planning. Using point forecasts with upper 95% prediction intervals, such forecasting methods would have provided better accuracy in anticipating required beds on COVID-19 hospital units than ward-level capacity decisions made by hospital staff. We have integrated our methodology into a publicly available online tool that operationalizes ward-level forecasting to aid with capacity planning decisions. Importantly, hospital staff can use this tool to translate forecasts into better patient care, less burnout, and improved planning for all hospital resources during pandemics.

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预测病房级床位需求以帮助疫情资源规划:经验教训和未来方向。
在新冠肺炎大流行期间,人们对如何利用区域和国家层面的预测来预测所需的医院资源进行了大量研究。我们在这项工作的基础上,重点关注疫情期间医院工作人员的病房级预测和规划工具。我们介绍了一种工作原型预测工具的评估、验证和部署,该工具在疫情期间用于资源规划的改进交通控制捆绑(TCB)协议中使用。在不列颠哥伦比亚省新冠肺炎大流行的前三波中,我们将加拿大最大的医院之一(温哥华综合医院)与加拿大温哥华的中型医院(圣保罗医院)的统计和机器学习预测方法及其准确性进行了比较。我们的结果证实,传统的统计和机器学习(ML)预测方法可以提供有价值的病房级预测,以帮助疫情资源规划的决策。使用95%以上预测区间的点预测,与医院工作人员做出的病房容量决定相比,这种预测方法在预测新冠肺炎医院单元所需床位方面提供了更好的准确性。我们已将我们的方法集成到一个公开的在线工具中,该工具可操作病房级别的预测,以帮助做出容量规划决策。重要的是,医院工作人员可以使用这一工具将预测转化为更好的患者护理、更少的倦怠感,并改进疫情期间所有医院资源的规划。
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来源期刊
Health Care Management Science
Health Care Management Science HEALTH POLICY & SERVICES-
CiteScore
7.20
自引率
5.60%
发文量
40
期刊介绍: Health Care Management Science publishes papers dealing with health care delivery, health care management, and health care policy. Papers should have a decision focus and make use of quantitative methods including management science, operations research, analytics, machine learning, and other emerging areas. Articles must clearly articulate the relevance and the realized or potential impact of the work. Applied research will be considered and is of particular interest if there is evidence that it was implemented or informed a decision-making process. Papers describing routine applications of known methods are discouraged. Authors are encouraged to disclose all data and analyses thereof, and to provide computational code when appropriate. Editorial statements for the individual departments are provided below. Health Care Analytics Departmental Editors: Margrét Bjarnadóttir, University of Maryland Nan Kong, Purdue University With the explosion in computing power and available data, we have seen fast changes in the analytics applied in the healthcare space. The Health Care Analytics department welcomes papers applying a broad range of analytical approaches, including those rooted in machine learning, survival analysis, and complex event analysis, that allow healthcare professionals to find opportunities for improvement in health system management, patient engagement, spending, and diagnosis. We especially encourage papers that combine predictive and prescriptive analytics to improve decision making and health care outcomes. The contribution of papers can be across multiple dimensions including new methodology, novel modeling techniques and health care through real-world cohort studies. Papers that are methodologically focused need in addition to show practical relevance. Similarly papers that are application focused should clearly demonstrate improvements over the status quo and available approaches by applying rigorous analytics. Health Care Operations Management Departmental Editors: Nilay Tanik Argon, University of North Carolina at Chapel Hill Bob Batt, University of Wisconsin The department invites high-quality papers on the design, control, and analysis of operations at healthcare systems. We seek papers on classical operations management issues (such as scheduling, routing, queuing, transportation, patient flow, and quality) as well as non-traditional problems driven by everchanging healthcare practice. Empirical, experimental, and analytical (model based) methodologies are all welcome. Papers may draw theory from across disciplines, and should provide insight into improving operations from the perspective of patients, service providers, organizations (municipal/government/industry), and/or society. Health Care Management Science Practice Departmental Editor: Vikram Tiwari, Vanderbilt University Medical Center The department seeks research from academicians and practitioners that highlights Management Science based solutions directly relevant to the practice of healthcare. Relevance is judged by the impact on practice, as well as the degree to which researchers engaged with practitioners in understanding the problem context and in developing the solution. Validity, that is, the extent to which the results presented do or would apply in practice is a key evaluation criterion. In addition to meeting the journal’s standards of originality and substantial contribution to knowledge creation, research that can be replicated in other organizations is encouraged. Papers describing unsuccessful applied research projects may be considered if there are generalizable learning points addressing why the project was unsuccessful. Health Care Productivity Analysis Departmental Editor: Jonas Schreyögg, University of Hamburg The department invites papers with rigorous methods and significant impact for policy and practice. Papers typically apply theory and techniques to measuring productivity in health care organizations and systems. The journal welcomes state-of-the-art parametric as well as non-parametric techniques such as data envelopment analysis, stochastic frontier analysis or partial frontier analysis. The contribution of papers can be manifold including new methodology, novel combination of existing methods or application of existing methods to new contexts. Empirical papers should produce results generalizable beyond a selected set of health care organizations. All papers should include a section on implications for management or policy to enhance productivity. Public Health Policy and Medical Decision Making Departmental Editors: Ebru Bish, University of Alabama Julie L. Higle, University of Southern California The department invites high quality papers that use data-driven methods to address important problems that arise in public health policy and medical decision-making domains. We welcome submissions that develop and apply mathematical and computational models in support of data-driven and model-based analyses for these problems. The Public Health Policy and Medical Decision-Making Department is particularly interested in papers that: Study high-impact problems involving health policy, treatment planning and design, and clinical applications; Develop original data-driven models, including those that integrate disease modeling with screening and/or treatment guidelines; Use model-based analyses as decision making-tools to identify optimal solutions, insights, recommendations. Articles must clearly articulate the relevance of the work to decision and/or policy makers and the potential impact on patients and/or society. Papers will include articulated contributions within the methodological domain, which may include modeling, analytical, or computational methodologies. Emerging Topics Departmental Editor: Alec Morton, University of Strathclyde Emerging Topics will handle papers which use innovative quantitative methods to shed light on frontier issues in healthcare management and policy. Such papers may deal with analytic challenges arising from novel health technologies or new organizational forms. Papers falling under this department may also deal with the analysis of new forms of data which are increasingly captured as health systems become more and more digitized.
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