healthcare workers Krannert faculty member Pengyi Shi led a patient-flow workload team to create a model for managing coronovirus surges at IU Health. (Stock photo)

Pandemic Partners

Krannert and Kelley collaborate to help IU Health manage surge of COVID-19 patients

Faculty at two of Indiana’s leading business schools are collaborating on a project with IU Health to help the healthcare provider manage the COVID-19 demand surge in their 16 hospitals across five regions of the state.

The interdisciplinary team of professors at Purdue’s Krannert School of Management and Indiana's Kelley School of Business began working in late March to develop a predictive model of the resources required for an adequate response to the pandemic. This includes both disease prediction and patient flow workload.

Pengyi Shi, assistant professor of supply chain and operations management at Krannert, led the patient-flow workload team.

“In my role, I led a team to develop a model of how COVID-19 patients move around the hospital and what resources they use during their stay, such as medical/surgical and ICU beds, ventilators and ECMOs, nurse staff, and PPE,” says Shi. “I developed a model based on a queueing network and programmed it in Excel with easily modifiable parameters for practitioners to evaluate different potential scenarios and operational interventions.” 

Shi’s research focuses on building data-driven, analytical methods to support decision-making under uncertainty in various healthcare systems. Her most recent publication, “Timing it Right: Balancing Inpatient Congestion versus Readmission Risk at Discharge,” won the Pierskalla Best Paper Award at the 2018 meeting of the INFORMS Health Applications Society. It is forthcoming in the journal Operations Research.

From minds to models

Another of the team’s co-leaders, Jonathan Helm, associate professor of operations and decision technologies and Grant Thornton Scholar at Kelley, says many models for COVID-19 lack the details needed for hospitals to do operational planning.

“A lot of models out there that predict the number of ICUs and ventilators you’re going to need really are back of the envelope calculations,” Helm says.  “For example, patient resource requirements in Indianapolis look different from those for patients in Lafayette and Bloomington. These regions have different types of hospitals and different demographics of people they serve, and different population densities, all of which contribute to COVID-19 care resource requirements.

“We are creating a learning model of how the patients in each region of Indiana are being affected and how they differ from those in the national model,” Helm says.

Helm and four others in Kelley’s Department of Operations and Decision Technologies developed a SEIR disease progression model, which aims to predict when surges of COVID-19 patients might take place around the state.

Combining this with Shi’s workload model has allowed IU Health to predict the impact of operational measures potentially activated as part of a COVID-19 surge plan. Examples include cancelling elective surgeries, transforming ambulatory surgery rooms into ICUs, modifying staff plans and schedules, leveraging the flexible “float” nurse pool to move nurses to where patient care is most needed, shipping ventilators between regions, preparing for pharmacy loads, and potentially setting up temporary hospitals.

The team worked day and night due to the urgency of the situation and is now providing weekly updates to IU Health as the model is able to learn and improve from the evolving new data about COVID-19 patients.

The team also is exploring the possibility of having the tool deployed statewide beyond IU Health.

“I’m excited about the opportunity to use my research in patient flow modeling to help hospitals in their operational response to this highly disruptive pandemic,” Shi says. “The involvement of Purdue and Krannert in this project provides recognition for the school and the university as key players in the solution to this unprecedented outbreak.”

“This effort shows the incredible talent and hardworking nature of our faculty,” says Idalene “Idie” Kesner, dean of the Kelley School and the Frank P. Popoff Chair of Strategic Management. “It also shows how Hoosiers come together from across the state for the benefit of the Indiana community.”

David Hummels, the Dr. Samuel R. Allen Dean of the Krannert School, serves on the board for the IU Health West Central Region. He praised the effort and collaborative approach by Shi and those at Kelley.

“The rapid adjustments that have been made throughout the IU Health system in order to accommodate patient surge have been nothing short of astonishing,” he says. “This is one of the times where they have to try many new things, very quickly, and put an enormous amount of trust in expertise that new systems are going to work.”

Driving positive outcomes

Dr. Jose Azar, chief quality officer at IU Health, says the predictive models have helped the healthcare provider anticipate the time and magnitude of the surge and place strategies to meet the anticipated demand on space, staff and resources for the crisis.

“My primary concern has been to avoid getting to the point where we don’t have enough equipment to keep our staff safe or don’t have enough resources to care for our patients,” he says. “The predictive model has helped us prepare for both scenarios.”

Based upon IU Health’s actual data during the pandemic, the predictive model also will assist in its financial planning. “The great part about the tool is the ability to model when and at what level elective procedures will begin,” says Scott Black, chief financial officer of system clinical services at IU Health. “Those assumptions will allow us to make more informed financial results and cash flow projections.”

“Having an analytical partner help us determine when and where we needed to align people, processes, medication, and supplies in a way that allowed us to minimize medication shortages and rework was valuable in focusing our energy on delivering clinical and operational outcomes,” adds Buck Sanders, vice president and chief pharmacy officer at IU Heath. “We truly appreciate the partnership in helping us fulfill our promise.”

Today, more than six months later, the team is not slowing its efforts as subsequent waves of the virus build across the state. “We are diligently monitoring how new cases are evolving,” Shi says. “We just need to be prepared.”