Journal article

Model-informed health system reorganization during emergencies

  • Gonçalves, Paulo ORCID Institute of Management and Organisation (IMO), Facoltà di scienze economiche, Università della Svizzera italiana, Svizzera
  • Ferrari, Paolo Ente Ospedaliero Cantonale (EOC), Head Office and Department of Nephrology, Ospedale Regionale di Lugano (Civico), Lugano, Switzerland
  • Crivelli , Luca Scuola Universitaria Professionale della Svizzera italiana (SUPSI), Department of Business Economics, Health and Social Care, Manno, Switzerland
  • Albanese, Emiliano ORCID Institute of Public Health (IPH), Università della Svizzera italiana, Switzerland
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  • 2022
Published in:
  • Production and operations management. - 2022, vol. 32, no. 5, p. 1-22 [in issue: 1323-1344]
English The COVID-19 pandemic presented the world to a novel class of problems highlighting distinctive features that rendered standard academic research and participatory processes less effective in properly informing public health interventions in a timely way. The urgency and rapidity of the emergency required tight integration of novel and high-quality simulation modeling with public health policy implementation. By introducing flexibility and agility into standard participatory processes, we aligned the modeling effort with the imposed reality of the emergency to rapidly develop a regional system dynamics (SD) model integrating diverse streams of data that could reliably inform both health system restructuring and public health policy. Using Lombardy data, our SD model was able to generate early projections for the diffusion of the pandemic in neighbor Ticino. Later, it projected the timing and size of peak patient demand. Our work also supported the need for reorganization of the healthcare system and volume flexibility strategies increasing hospital capacity (e.g., intensive care unit [ICU] and ward beds, medical and nursing staff, and oxygen supply) in Ticino. Counterfactual analyses quantify the impact of the decisions supported by our interventions. Our research contributes to our understanding of volume flexibility strategies used by healthcare organizations during emergencies, highlighting the critical role played by available response time in the deployment of strategies that either prioritize critical services or leverage available resources. It also contributes to the literature on participatory systems modeling by describing a flexible and agile participatory process that was successfully deployed in a rapidly evolving high-stakes emergency.
  • English
Social sciences
Open access status
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