A severe influenza pandemic could overwhelm hospitals, but planning guidance that accounts for specifics is lacking. For example, changing bed or ventilator capacity affects staffing, supply, and pharmaceutical needs and vice versa. Previous models did not adequately account for operational chokepoints and bottlenecks, such as emergency department throughput and dynamic staffing patterns.
To address the issue, Mark Abramovich of Interdisciplinary Solutions, LLC, decided to apply Monte Carlo simulation via @RISK. Working with several other experts, the team gathered epidemiologic variables, historical information such as the 1918 influenza pandemic in London, and particular data from Mayo Clinic Hospital – Rochester as a test case. All this vital data was used to run 10,000 Monte Carlo simulations on @RISK, using various combinations of variables to determine resource needs across a spectrum of scenarios.
“Although Monte Carlo simulation cannot identify the single best strategy, it allows the decision maker to understand the range of potential outcomes and how they change based on differing assumptions, and allows for decision making with respect to uncertainty and the user’s risk tolerance,” says Abramovich. Through this approach, he and his team projected supplies needs for a range of scenarios that use up to 100% of Mayo Clinic’s surge capacity of beds and ventilators. The results indicate that there are diminishing patient care benefits for stockpiling on the high side of the range, but that having some stockpile of critical resources, even if it is relatively modest, is most important.
Byron Callies, MSHS, Mayo Clinic’s Director for Clinical & Business Continuity Management, said, “This modeling approach provided a rational basis for informed decision making for our disaster stockpile needs. As a result, by establishing a common level of preparedness based on the modeling outcomes and the organization’s risk tolerance, we were able to align and improve preparedness efforts across multiple functional groups while at the same time being good stewards of the organization’s resources.”
