RAND Critical Care Surge Response Tool

This Excel-based model allows decisionmakers at all levels (i.e., hospitals, health care systems, states, regions) to examine the current critical care capacity in the nation’s hospitals and rapidly explore strategies for increasing capacity to provide care for the sickest COVID-19 patients. The tool was developed by the RAND Corporation in response to the 2020 COVID-19 pandemic.

Model input parameters to the Excel spreadsheet include baseline number of beds, critical care doctors and nurses, respiratory therapists, and ventilators. The user can also specify baseline numbers of intensive care unit (ICU) doctors, ICU nurses, and respiratory therapists per shift and ratios of these providers to patients (shift lengths are defined by the user and require no additional inputs). Further, the user can indicate additional spaces that can be created and used as ICU space (e.g., through doubling patients in ICU rooms, or using post-anesthesia unit space) and additional ventilators (e.g., through purchasing or sharing with other facilities) that can be added to create critical care surge capacity. Finally, it allows users to input information (i.e., the ratios of supervisor to extender and extender to patients) related to how critical care physicians, critical care nurses, and respiratory therapists might act as supervisors for “extender” care providers in case not enough fully capable personnel can be brought in.

With the information provided, the model estimates the number of patients who can be cared for. Moreover, it identifies which among the three of staff (critical care doctors, critical care nurses, and respiratory therapists), space (beds), and stuff (ventilators) resources is the limiting factor in increasing capacity.