Alternate Level of Care Patients in Canada: a Scoping Review.

Background: There has been increasing concern over the growing number of Alternate Level of Care (ALC) patients in Canada who must wait in hospitals for more appropriate settings to meet their needs. ALC patients may have to stay in hospitals for days or months due to a lack of available long-term care capacity, home care services, or other discharge routes.

Method: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) method to review 35 papers on the topic of ALC patients and delayed discharge in Canada from different perspectives, including (1) the shared characteristics of ALC patients in Canada; and (2) their impact on the Canadian health-care system, medical staff, and family members.

A systematic literature review of predicting patient discharges using statistical methods and machine learning.

Discharge planning is integral to patient flow as delays can lead to hospital-wide congestion. Because a structured discharge plan can reduce hospital length of stay while enhancing patient satisfaction, this topic has caught the interest of many healthcare professionals and researchers. Predicting discharge outcomes, such as destination and time, is crucial in discharge planning by helping healthcare providers anticipate patient needs and resource requirements.

A framework for comparing N95 and elastomeric facepiece respirators on cost and function for healthcare use during a pandemic- A literature review.

SARS-CoV-2 has posed implications for personal protective equipment supply. In this literature review we examine if elastomeric facepiece respirators (EFRs) are effective substitutes for N95 respirators through comparing their functionality and cost. We reviewed 30 articles which researched the advantages and disadvantages of each respirator.

Assessment of COVID-19 barrier effectiveness using process safety techniques.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a respiratory illness called the novel coronavirus 2019 (COVID-19). COVID-19 was declared a pandemic on March 11, 2020. Bow tie analysis (BTA) was applied to analyze the hazard of SARS-CoV-2 for three receptor groups: patient or family member at the IWK Health Centre in acute care, staff member at a British Columbia Forest Safety Council (BCFSC) wood pellet facility, and staff member at the Suncor refinery in Sarnia, Ontario.

Distributionally robust optimization of a Canadian healthcare supply chain to enhance resilience during the COVID-19 pandemic.

This paper presents a multi-period multi-objective distributionally robust optimization framework for enhancing the resilience of personal protective equipment (PPE) supply chains against disruptions caused by pandemics. The research is motivated by and addresses the supply chain challenges encountered by a Canadian provincial healthcare provider during the COVID-19 pandemic. Supply, price, and demand of PPE are the uncertain parameters.

Optimal Transport Scenario With Rotary Air Transport for Access to Endovascular Therapy Considering Patient Outcomes and Cost: A Modeling Study.

For an ischemic stroke patient whose onset occurs outside of the catchment area of a hospital that is capable of Endovascular Treatment (EVT) and whose stroke is suspected to be caused by a large vessel occlusion (LVO), a transportation dilemma exists. Bypassing the nearest stroke hospital will delay Alteplase but expedite EVT. Not bypassing allows for confirmation of an LVO diagnosis before transfer to an EVT-enabled facility, but ultimately delays EVT.

Application of bow tie analysis and inherently safer design to the novel coronavirus hazard.

This work involves the application of process safety concepts to other fields, specifically bow tie analysis and inherently safer design (ISD) to COVID-19. An analysis framework was designed for stakeholders to develop COVID-19 risk management plans for specific scenarios and receptor groups. This tool is based on the incorporation of the hierarchy of controls (HOC) within bow tie analysis to identify priority barriers.

Simulation optimisation for mixing scheduled and walk-in patients.

Mixed registration type clinics accept both walk-in and scheduled patients. Such clinics provide patients with an additional option for how they access care while patient bookings help providers ensure a full workday. The model described in this paper determines how many patients to schedule (and when) in mixed registration type clinics.

A review on ambulance offload delay literature.

Ambulance offload delay (AOD) occurs when care of incoming ambulance patients cannot be transferred immediately from paramedics to staff in a hospital emergency department (ED). This is typically due to emergency department congestion. This problem has become a significant concern for many health care providers and has attracted the attention of many researchers and practitioners.

Offload zones to mitigate emergency medical services (EMS) offload delay in the emergency department: a process map and hazard analysis.

Unlabelled: Introduction Offload delay is a prolonged interval between ambulance arrival in the emergency department (ED) and transfer of patient care, typically occurring when EDs are crowded. The offload zone (OZ), which manages ambulance patients waiting for an ED bed, has been implemented to mitigate the impact of ED crowding on ambulance availability. Little is known about the safety or efficiency.

A review on the relation between simulation and improvement in hospitals.

Background: Simulation applications on operations management in hospitals are frequently published and claim to support decision-making on operations management subjects. However, the reported implementation rates of recommendations are low and the actual impact of the changes recommended by the modeler has hardly been examined. This paper examines: 1) the execution rate of simulation study recommendations, 2) the research methods used to evaluate implementation of recommendations, 3) factors contributing to implementation, and 4) the differences regarding implementation between literature and practice.

ORchestra: an online reference database of OR/MS literature in health care.

We introduce the categorized reference database ORchestra, which is available online at http://www.utwente.nl/choir/orchestra/.

Accounting for inpatient wards when developing master surgical schedules.

Background: As the demand for health care services increases, the need to improve patient flow between departments has likewise increased. Understanding how the master surgical schedule (MSS) affects the inpatient wards and exploiting this relationship can lead to a decrease in surgery cancellations, a more balanced workload, and an improvement in resource utilization. We modeled this relationship and used the model to evaluate and select a new MSS for a hospital.

A comprehensive simulation for wait time reduction and capacity planning applied in general surgery.

This paper describes the use of operational research techniques to analyze the wait list for the Division of General Surgery at the Capital District Health Authority in Halifax, Nova Scotia, Canada. A discrete event simulation model was developed to aid capacity planning decisions and to analyze the performance of the division. The analysis examined the consequences of redistributing beds between sites, and achieving standard patient lengths of stay, while contrasting them to current and additional resource options.