Simulation models to predict biochemistry test capacity in Covid-19 pandemic surge capacity planning in tertiary care centres

ABSTRACT

Background-aim: The COVID-19 pandemic has re-emphasized the need for the timely delivery of clinical laboratory results to support optimal patient care. The objective of this study was to determine if current instrumentation in Saskatoon hospital chemistry laboratories could accommodate the anticipated COVID workload in addition to non-COVID testing for the existing acute care hospitals and proposed field hospitals. Methods: A simulation model was utilized to assess workload and turn-around-time (TAT) capacity for pre-analytic, total analytic, chemistry, ion-selective-electrode and immunoassay testing to accommodate an expanded COVID workload. Anticipated COVID patient numbers and a COVID specific test menu were incrementally introduced into a 24 hour pre-COVID testing workload. The impact of field hospital location, courier schedule and daily instrument maintenance schedule were also considered when calculating a TAT from specimen collection to result reporting. Results: Instrumentation throughput, scheduled times for instrument daily maintenance and the time of day when the specimen surge is received in the laboratory were found to be significant predictors of laboratory’s ability to accommodate anticipated COVID workload. Courier schedule and proximity of the field hospital to the laboratory significantly influenced the TAT for field hospital testing. Conclusions: A simulation model is a helpful tool to provide useful information for optimal delivery of multi-site clinical laboratory services during the COVID-19 pandemic.