OR helps dialysis services work better during COVID-19

A team drawn from the University of Exeter and Portsmouth Hospitals NHS Trust has completed a study which is already helping improve services to patients requiring dialysis in the south of England.

Dialysis patients habitually travel in ambulances to medical centres for their treatment, creating a significant volume of non-emergency transportation. These patients are particularly vulnerable to COVID-19, adding another dimension of care to consider when providing their essential renal replacement therapy.

Members of PenCHORD (the Peninsula Collaboration for Health Operational Research and Data Science) partnered with researchers from the University of Exeter’s Institute for Data Science and Artificial Intelligence (IDSAI) to conduct the research. They used computer modelling to identify how to reorganise dialysis services and minimise disruption to 650 patients receiving treatment at the Wessex Kidney Centre.

The team applied advanced computer simulation methods to a range of infection scenarios and assessed the capacity of services to continue providing dialysis to patient groups who are infected or not infected with COVID-19. The simulations included measures to prevent cross-infection between subgroups of inpatients and outpatients.

The project recommended transporting multiple patients per journey, a move which would reduce the burden on the ambulance service by up to 60 percent. Infected patients would also be given access to temporary accommodation close to their treatment centres. The study found that the most resilient approach was to centralise care of infected outpatients usually treated in the Wessex region at the Queen Alexandra Hospital in Portsmouth, with surge capacity at Basingstoke Hospital. 

The team submitted their findings within two weeks. Portsmouth Hospitals NHS Trust’s Renal Information and Systems Manager Jonas Willemsen said: “We’re bowled over by how quickly the team turned this around. I think this is going to be, and indeed already is, transformative to our handling of the COVID-19 outbreak.”

University of Exeter operational researcher Dr Tom Monks said: "This was collaborative research at its best. Working closely with our NHS colleagues is always rewarding. The work took place in the early stage of the pandemic and the team felt that, if we were quick, we had a real opportunity to contribute to the NHS planning effort to keep a vulnerable group of people safe. It was fantastic to see how rapidly colleagues across the University and NIHR PenARC could mobilise their expertise."

Full story on Exeter University's news page