Preparing for the influx of patients as elective care restarts and facing further surges with resiliency

Since the outbreak of COVID-19, routine care has come to a standstill. Models predicted a 60-80% decline in elective procedures in Q2 of 2020 for EU and US, and an additional 40-50% decline in Q3. When the recovery does begin, it could be accompanied by a resurgence of demand for both elective and delayed essential procedures that strains business models and financial resilience.¹

The longer non-urgent care is delayed, the more urgent it eventually becomes. Much of the care that has been put on hold will have to be made up quickly as healthcare organizations restart and there will be additional surges in new COVID-19 cases in the coming months that could disrupt the plan.

At the same time, new patients continue to present with care concerns – a stream that will need to be merged with the backlog. The question of how you can manage more patients in a shorter period of time is more relevant than ever. Healthcare organizations must not only be prepared to catch up with elective cases to keep their populations healthy, but also to become resilient and adaptable to fluctuating demands. Solutions to this ‘new normal’ require new ways of working, more efficient organization of care, and infusion of innovation.  

There is a large regional variability in the impact of the COVID-19 crisis and consequently restarting postponed care will be regionally different.¹ Any response must be carefully tailored to address local conditions. As healthcare services re-emerge in the initial recovery from the intense social distancing of the past months, the following realities become clear:

• We need a safe and cautious approach to re-introducing elective care
• We need to be agile in the event of peaks and valleys in the come-back phase
• We need to rethink the way we plan and deliver care in the future

There are opportunities for healthcare organizations to prepare for the future now, with a focus on: 

• A well-planned and efficient restart and smooth ongoing management of routine care in light of requirements resulting from COVID-19 - for example, social distancing in the care areas
• Periodic increases in demand as the community recovers
• Expanded care at a distance (virtual care) to move as much of the prep and recovery out of the healthcare facility and into the home

Healthcare organizations who are able to quantify and effectively plan for handling the backlog, and merging that with new cases, have the greatest chance to reduce ongoing waiting time – with all its consequences – as we evolve out of the initial COVID-19 crisis period.

The first action is to gain insight into the extent of care that has been delayed and still needs to be delivered, anticipate the influx of new patients requiring care, and then determine how well this demand can be accommodated with the available capacity in terms of equipment, space, operating hours and care providers. 

Based on your trends in patient volumes over the past year and through analysis of patient profiles on the list of cases on hold, our consultants can extrapolate an informed volume for the current 'backlog' of care. By plugging these demand assumptions into our modeling tools, together with your capacity figures, we get a customized insight into the impact of this backlog on the organization or department. We then develop various ‘what-if’ scenarios by adjusting variables that are flexible and infuse potential new ways of working. We work with you to determine the strengths and feasibility of the different approaches to support you in making decisions about which adjustments make the most sense for your specific situation and capabilities.

With insights into the extent of the accumulated backlog and flexibility of parameters surrounding your typical patient flow and capacity, challenges to achieving a smooth and sustainable flow may emerge. It is important to visualize solutions that can make the demand for care achievable. 

Solutions may involve enhanced use of technology, workflow optimization, spatial layout adjustments, sharing of care across a network, cross-training and elasticity of staffing patterns, and phased care for selected patient populations. In short, you must make the time the patient spends in the care area [e.g. imaging department] most effective – targeted at the specific clinical demands for the service provided. The goal is not to do what you used to do faster, but rather to innovate on processes in a way that makes them resilient, to ensure the best use of available resources, and then adapt, augment, and expand as necessary.

Considerations in this phase may involve a temporarily scaling up to protect the most vulnerable patients for whom a deterioration in their condition may have significant consequences. In addition, these solutions should fundamentally improve the efficiency of how you deliver care in a manner that provides a safe environment and breeds confidence among your patients and staff. Based on strong collective experience, our consultants and point experts will collaborate with you and your teams to select the combination of flows and solutions with the greatest likelihood of success in handling the uncertainty of the upcoming period and to infuse resilience and adaptability into your ‘new normal’.

One thing is for certain – healthcare will continue to face rapid evolution in the coming time period and flexible options for care will be welcomed. Innovations, such as virtual care, have been available for some time, yet adoption has only now accelerated with this crisis. We are faced with the need to interact with and monitor people at home in order to prevent them from being exposed to the virus at the healthcare facility. We know this care-at-a-distance has tremendous ongoing value to ease the burden for both patients and care providers in managing routine aspects of care. When used effectively, it can enhance responsiveness and personalization, while reducing support staff, as well as administrative overhead.

With continual change comes the need for adaptability and resilience, so the need for scenario planning becomes a continuous cycle. What works today may not be the solution for tomorrow. Processes must to be put in place to monitor for and alert to deviations from the plan. They must trigger interventions that quickly deliver necessary care when and where it is most optimal for a positive patient outcome. 

Together with you, we will map out the care pathways and patient groups for which these innovative solutions in workflow and technology can be effectively applied. Some of the solutions can be started immediately to provide a fast restart of elective services and to support you through your backlog of pent-up demand. Supplementing traditional care with innovative solutions not only optimizes the use of existing resources, it helps stretch your capacity to see more patients. Studies show that introduction of digital solutions enhances patient experience and quality of care.²

Putting these innovations into place now helps you build your own experience so you can be better prepared for the peaks and valleys of the future. As we emerge from the current limitations imposed by COVID-19, you’ll be better able to manage a potential resurgence of the virus while effectively restarting routine care.  

We would be pleased to help your organization go forward and thrive in this world of the ‘new normal’.