Modelo discreto para proceso de atención a pacientes con Covid-19 en UCI (Unidad de Cuidados Intensivos) para controlar la saturación de pacientes implementando decisiones logísticas

Abstract

The recent emergency situation that occurred due to the communicable disease known as Covid-19 put the country's current health system at risk, since it did not have the adequate organization to deal with a large-scale pandemic. The situation faced by health agencies in the country was unprecedented, leading to a collapse in the health system due to not having adequate infrastructure and resources to address this situation. In search of alternatives to avoid the collapse of the health system, the present work arises to carry out a discrete model for the care process for patients with Covid-19 in the ICU (Intensive Care Unit) to control the saturation of patients by implementing logistical decisions. A characterization of the patient care system for Covid-19 used by the Health Provision Institutions (IPS) was carried out and through the collection of daily case reports provided by the Secretary of Health, the registration of patient admission to the emergency room by IPS and the investigation of the times established for the care of patients within their system, descriptive statistical analysis was carried out to determine the period of execution of the model according to the behavior of the pandemic, the selection of the distributions to be used in the different emergency services and their adjustment. In the allocation of beds, a Petri net was implemented and the logistical events that the system should have were established in order to later implement the digital twin of the process using the Simio simulation software. The simulation results of the implementation of the model within the software initially presented a saturation of beds at the highest peak of the pandemic, the use of the reception, triage, test taking and medical observation modules was also validated, which did not they were used in the best way, causing a loss of resources in the system, so when these situations arise, a second scenario is created with the improvements and its results reflect the non-saturation of the beds, as well as a greater use of the modules. care, reducing possible costs to the IPS. The results section shows in detail the admissions of patients for their care, the use of services, the diagnosis of medical observation, the status of critical patients, the occupation of beds, the improvements implemented, the length of stay , among other important aspects that allow a solution to the problem raised.