A team of engineers from the Institute for Manufacturing at the Cambridge University has used modelling tools designed to boost factory efficiencies to help a local hospital better manage sudden surges in patient numbers.
Hospitals are facing a “triple whammy of pressures”, according to Saffron Cordery, CEO of NHS Providers – membership organisation for the NHS hospital, mental health, community and ambulance services.
During the most challenging year in NHS history, hospitals now face winter itself, including the prospect of flu, the ongoing pandemic and possible second surge, and trying to recover their position and restart ‘usual services’.
Now, a team from the University’s Department of Engineering are using modelling tools originally designed to improve the efficiency of factories to help Addenbrooke’s Hospital manage the COVID-19 emergency.
The work was done in parallel with the hospital’s own modelling and provides insight into how day-to-day activities might be affected by a rise in patient numbers in the coming weeks or months.
‘Discrete event simulations’ have been worked up to manage the flow of patients through hospital wards in the event of a surge in cases, and anticipate waiting times, bed availability, and equipment and staff shortages.
Systemic resource planning
“We started with a flow diagram of how we thought the hospital worked, then talked it through with the team at Addenbrooke’s,” explained Dr Ajith Parlikad, who lead on the simulation development.
“It was quite close to their own model, but we were able to factor in more details, such as ICU beds, ‘COVID-positive’ beds [patients with the virus who don’t require intensive care], and the initial checking and testing process when patients arrive – everything has a statistical distribution associated with it.”
As well as patient flow modelling, the Department’s industrial engineering students volunteered their time to focus on the hospital’s oxygen supply, among other things how it might be replenished and filtered, and explored how to model and optimise COVID-19 testing processes.
In addition, further work is beginning on modelling that will help the hospital better understand staffing level availability during disruptions such as the COVID-19 outbreak.
Duncan McFarlane, Professor in Industrial Information Engineering, said: “Three months ago, we knew very little about hospital operations, but with close input from the hospital we’ve been able to pick from a series of industrial techniques and apply the most useful ones to this new setting.
“Instead of production lines we’re now looking at hospital wards, and rather than products or raw materials we are examining the flow of patients and supplies.”
Key takeaways for manufacturers
Duncan has identified several things manufacturers can learn from this work.
Firstly, how quickly hospitals can cease all non COVID-related activities compared to starting them up again – shutting down is far quicker than restarting. Secondly, the planning that needs to be done into long-term COVID-surge scenarios. as
“It’s not like saying, ‘we’ve been sick and now we’re recovering’, there’s a lot of planning for future scenarios,” Duncan continues. “It’s a balancing act for manufacturers either in their ability to absorb and/or adapt at the time of a shutdown and then planning for how they will operate through a second wave.”
Duncan and his team have been investigating four areas in particular:
- No touch operations such as voice and gesture image procession, especially beneficial for dispensing systems.
- Distant and remote monitoring to help enhance or extend the monitoring of processes and equipment, especially in environments where access is complex or compromising.
- Reconfigurability¸ i.e. how easily manufacturers adapted their operations to produce goods outside of their norm, such as PPE and medical device components.
- Track and trace; many hospitals and care providers experienced issues sourcing PPE and equipment, not just from the centralised supply chain, but within a sprawling organisation. Therefore, how goods can be accurately logged and tracked to instantly determine their location when needed is vital.
Dr Ewen Cameron, director of Improvement and Transformation at Cambridge University Hospitals, commented: “At this time of unprecedented change for the NHS, our teams are working around the clock to set up innovative ways of working to best care for patients and protect our staff.
“New challenges require new ways of thinking, and we are hugely grateful to the Institute for Manufacturing for offering their expertise to help us beat the virus.”