Optimal Hospital Capacity Management During Demand Surges

TL;DR

This paper introduces a data-driven, optimization-based framework for hospital capacity management during demand surges, aiming to improve patient care and operational efficiency amidst fluctuating demands like during the COVID-19 pandemic.

Contribution

It develops a robust mixed-integer linear programming model for optimizing capacity allocation and patient transfers, incorporating practical constraints and costs, and demonstrates its effectiveness through retrospective analysis.

Findings

Potential to reduce surge capacity needs by nearly 90%

Optimal patient transfers can significantly improve system resilience

Framework provides actionable decision support during demand spikes

Abstract

Effective hospital capacity management is pivotal for enhancing patient care quality, operational efficiency, and healthcare system resilience, notably during demand spikes like those seen in the COVID-19 pandemic. However, devising optimal capacity strategies is complicated by fluctuating demand, conflicting objectives, and multifaceted practical constraints. This study presents a data-driven framework to optimize capacity management decisions within hospital systems during surge events. Two key decisions are optimized over a tactical planning horizon: allocating dedicated capacity to surge patients and transferring incoming patients between emergency departments (EDs) of hospitals to better distribute demand. The optimization models are formulated as robust mixed-integer linear programs, enabling efficient computation of optimal decisions that are robust against demand uncertainty. The models incorporate practical constraints and costs, including setup times and costs for adding surge capacity, restrictions on ED patient transfers, and relative costs of different decisions that reflect impacts on care quality and operational efficiency. The methodology is evaluated retrospectively in a hospital system during the height of the COVID-19 pandemic to demonstrate the potential impact of the recommended decisions. The results show that optimally allocating beds and transferring just 32 patients over a 63 day period around the peak, about one transfer every two days, could have reduced the need for surge capacity in the hospital system by nearly 90%. Overall, this work introduces a practical tool to transform capacity management decision-making, enabling proactive planning and the use of data-driven recommendations to improve outcomes.