Towards Health System Resiliency: An Agile Systems Modelling Framework for Bed Resource Planning During COVID-19

Abstract

Background: We describe the development of a dynamic simulation modelling framework to support agile resource planning during the COVID-19 pandemic. The framework takes into consideration the dynamic evolution of the pandemic and the rapidly evolving policies and processes to deal with the ever-changing outbreak scenarios.Methods: A specific use case based on short-term bed resource planning is described within the proposed framework. The simulation model was calibrated against historical data for the Singapore COVID-19 situation. The time period for model calibration was from 1st April till 30th April 2020. The model was used to project for bed resource needs over the period from 1st May 2020 till 31st May 2020. Multivariate sensitivity analysis was also conducted for ICU and general isolation bed demand, length-of-stay (LOS), and age-adjusted conversion rates across different care needs. The unmet needs under various scenarios were also evaluated for planning purposes.Results: Several variants of the agile resource planning model were developed to adapt to the fast-changing COVID-19 situation in Singapore. The use case demonstrated an agile adaptation of the model to account for previously unexpected scenarios. The rapid evolution of the pandemic locally revealed streams of new infections that arose from two distinct sources. The model projections were calibrated with the latest data for short-term projections. The agility in flexing plans and collaborative management structures to rapidly deploy human and capital resources to surge the level of care during the COVID-19 pandemic have proven utility in guiding the allocation of scarce healthcare resources and helped system resiliency.Conclusions: The rapidly evolving COVID-19 pandemic in Singapore has necessitated the development of an agile and adaptable modelling framework that can be quickly calibrated to changes both from demand and supply. The modelling framework is able to deploy systems modelling concepts in a holistic manner. This facilitates the evaluation of complex cause-and-effect relationships. A robust collaborative framework, coupled with the availability of in-depth domain knowledge and accurate and updated data availability ensures a model is realistic, timely and useful.