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How to protect healthcare workforce during an epidemic outbreak: Modelling a desynchronization strategy from the COVID-19 pandemic

English title How to protect healthcare workforce during an epidemic outbreak: Modelling a desynchronization strategy from the COVID-19 pandemic
Applicant Beldi Guido
Number 196059
Funding scheme Special Call on Coronaviruses
Research institution Universitätsklinik für Viszerale Chirurgie und Medizin Inselspital
Institution of higher education University of Berne - BE
Main discipline Mathematics
Start/End 01.06.2020 - 31.05.2022
Approved amount 296'250.00
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Keywords (4)

healthcare workers; mathematical modelling; infection rates; COVID-19

Lay Summary (German)

Lead
Wie können Mitarbeiter im Gesundheitswesen in einer Epidemie optimal geschützt werden?
Lay summary

Während weltweiter Pandemien ist der Schutz des medizinischen Personals eine entscheidende und herausfordernde Aufgabe. In solchen ausserordentlichen Situationen ist die Nachhaltigkeit der Gesundheitsdienstleister unter anderem durch 1) infizierte Patienten, 2) infizierte Mitarbeiter und 3) infizierte Personen ausserhalb des Spitals bedroht. Im Gegensatz zu den meisten anderen Berufen ist social distancing in medizinischen Teams, in denen enger Kontakt mit Patienten und Kollegen die Regel ist, sehr schwierig. Gegenwärtig ist wenig darüber bekannt, welche arbeitsorganisatorische Strategie in Krankenhäusern am besten geeignet ist um das Gesundheitspersonal zu schützen. Daher zielt das aktuelle Projekt darauf ab, herauszufinden, ob organisatorische Maßnahmen, die während des COVID-19-Ausbruchs eingeführt wurden, wirksam zum Schutz des medizinischen Personals beigetragen haben.

Ziel 1.    Bestimmung des Unterschieds im Infektionsrisiko zwischen medizinischem und nicht medizinischem Personal in einer Krankenhausumgebung

Ziel 2.    Bestimmen der Auswirkungen von Sars-CoV 2 Tests auf das Gesundheitspersonal

Ziel 3.    Bestimmen der Wirksamkeit organisatorischen Strategien zum Schutz des Gesundheitspersonals

Mit den in den Zielen 1, 2 und 3 gesammelten empirischen Daten werden mathematische Modelle entwickelt, getestet und simuliert, um die Auswirkungen zu evaluieren. Darüber hinaus sollen die Studien die Produktivität der Arbeitskräfte messen und modellieren, die sich aus den verschiedenen Organisationsstrategien ergibt.

Bedeutung

Im Rahmen dieses Projekts wird die Auswirkung des COVID-19-Ausbruchs auf die Belegschaft eines großen Universitätskrankenhauses analysiert um zu verstehen wie Mitarbeitende im Gesundheitswesen optimal geschützt werden können. Angesichts der Tatsache, dass aus dem Universitätsspital Daten für viele Berufe außerhalb des Gesundheitswesens verfügbar sind, können die Ergebnisse zum Teil auch ausserhalb des Spitals von Relevanz sein.

Direct link to Lay Summary Last update: 18.05.2020

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Abstract

During worldwide pandemics, protecting caregivers and thereby maintaining the medical workforce is a crucial and challenging task. Under such extraordinary situations, the sustainability of the healthcare providers is threatened by several factors including: 1) infected patients, 2) infected co-workers and 3) the infected community. Unlike most other professions, social distancing is extremely difficult in medical teams where healthcare workers are required to work in close contact with patients and colleagues. Currently, little is known about which work organizational strategy in hospitals is most suitable to protect the healthcare workforce. Therefore, the current project aims to identify if organizational measures installed during the COVID-19 outbreak were effective in protecting caregivers. This is of high relevance as during the course of an epidemic the healthcare workforce may become a scarce resource during later phases of the epidemic.The proposed project is designed to analyze data from the current COVID-19 outbreak to understand how organizational approaches may protect the healthcare workforce in a large university hospital. The obtained data will be used for the simulation and refinement of mathematical modelling to develop strategies that can be adapted for new regions affected by this, recurrent and future epidemic outbreaks. Aim 1. Determine the difference in risks of infection between healthcare and non-healthcare workers in a hospital environment The design of the study allows to determine the different roles on infection of hospital employees being 1) patient contact 2) no patient contact, working place in the hospital 3) home office. The model will determine to what extent these different roles impact of infection rates of workers and patients.Aim 2.Determine the impact of early testing on healthcare personnelAn intensive strategy of testing twice weekly for SARS-CoV-2 was established locally in one clinical unit. By assessing health status and productivity of the workforce compared to other departments allows to determine the relevance of frequent testing of asymptomatic healthcare workers for the protection of workers and patients. Aim 3.Determine the effectiveness of a desynchronization strategy to protect healthcare workersA desynchronization strategy was installed in one large unit in which the entire staff was dichotomized. Each of the two teams is working alternating for one week with the goal to reduce contact between the teams and decrease infection rates of the workforce. By comparing health status and productivity of the workforce to other departments will determine the relevance of such organizational distancing in healthcare workers. With the empirical data collected in Aims 1, 2 and 3, mathematical models will be developed, tested and simulated for impact evaluation. Modelling approaches address parametric as well as stochastic effects and extend the existing models that were developed for larger populations. Furthermore, the studies are designed to measure and model the productivity of the workforce resulting from the different organizational strategies. SignificanceWithin this project, the consequence of the COVID-19 outbreak on the workforce of a large university hospital will be analyzed and used to design new models for new regions affected, recurrent and future epidemic outbreaks. The results of this project will help to define the best strategy to organize the healthcare workforce of a hospital. The final goal is to be able to care for both infected and non-infected patients, while minimizing the risk to staff a thus maintaining a healthy caregiver workforce. Given the fact that data are available for many non-healthcare workers the results will also be modeled for non-healthcare institution. Therefore, these studies allow to determine the relevance of home office and desynchronization strategies to protect workers in their environment during and epidemic outbreak.
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